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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44438
Experience:  Board Certified Physician
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Our son requires a tracheostomy and has been diagnosed with

Customer Question

Our son requires a tracheostomy and has been diagnosed with TB. The doctors do not wish to carry out the surgery because of the risk of infection (to them). I understand that this operation could be safely carried out, assuming the correct protocols with regard to cross contamination are observed - is this correct?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

yes, a tracheostomy is a simple procedure and can be safely done on a patient who has TB.

Dr. David :

but after a tracheostomy is performed, a patient can often cough through the tracheostomy as they get use to breathing through the trach.

Dr. David :

so it is this coughing afterwards and the expulsion of air mucous particles through the air after the trach is inserted which can be dangerous for everyone around them.

Dr. David :

and everyone will need to be wearing a mask who is around him because he could very easily be coughing up mucous with TB in it out of his trach.

Dr. David :

does this make sense?

JACUSTOMER-uxy5rcn8- :

yes

Dr. David :

let me know if you have other questions.

JACUSTOMER-uxy5rcn8- :

yes

JACUSTOMER-uxy5rcn8- :

our son is in hospital and is sedated

Dr. David :

if his TB is being treated this helps reduce the risk for him to spread TB as well.

JACUSTOMER-uxy5rcn8- :

afetr heart attack

JACUSTOMER-uxy5rcn8- :

he is breathing thru ventilator

Dr. David :

if he is sedated his nurses and staff will also still have to suction out the trach from time to time to clear out mucous.

Dr. David :

the nurses can take precautions like masks and gloves to do this.

Dr. David :

he should be treated for TB as well

Dr. David :

and if he is treated, this also reduces the risk for spread .

JACUSTOMER-uxy5rcn8- :

a tracheostomy was due to go ahead

JACUSTOMER-uxy5rcn8- :

which I believe beneficial

JACUSTOMER-uxy5rcn8- :

but the hospital has declined

JACUSTOMER-uxy5rcn8- :

because of the TB

JACUSTOMER-uxy5rcn8- :

because of the risk of spreading infection

JACUSTOMER-uxy5rcn8- :

but I think this can be done safely

Dr. David :

yes, it can be done safely.

Dr. David :

but it can be more work for nurse and staff to care for the trach after it is done.

JACUSTOMER-uxy5rcn8- :

would yo agree with the doctors treating him

JACUSTOMER-uxy5rcn8- :

he is in isolation at present

Dr. David :

yes, he needs to be treated with TB medications.

Dr. David :

and long term intubation patients need a trach.

JACUSTOMER-uxy5rcn8- :

he is on tb meds at present

JACUSTOMER-uxy5rcn8- :

but being kept sedated

JACUSTOMER-uxy5rcn8- :

and during his conscious moments complains about the ventilator

JACUSTOMER-uxy5rcn8- :

which appears to be causing distress

Dr. David :

yes, a trach would help with that.

Dr. David :

once he gets use to breathing through the trach.

Dr. David :

the trach can get some getting use to.

JACUSTOMER-uxy5rcn8- :

the cost and difficulty of post op is not a consideration

JACUSTOMER-uxy5rcn8- :

do you think of the two possibilities

JACUSTOMER-uxy5rcn8- :

the trach would be the best one?

Dr. David :

yes.

JACUSTOMER-uxy5rcn8- :

I assume that you do not agree with the doctors stance

Dr. David :

yes.

Dr. David :

long term intubated and ventilated patients need a trach.

JACUSTOMER-uxy5rcn8- :

i am concerned that keeping him sedated for a long period is harmful

JACUSTOMER-uxy5rcn8- :

so far up to 10 days

JACUSTOMER-uxy5rcn8- :

he has been awoken but has difficulty breathing

JACUSTOMER-uxy5rcn8- :

whereas i feel the trach would allow this

Dr. David :

a trach would not help him with this breathing.

Dr. David :

his breathing is from his lung issues or TB infection.

Dr. David :

but a trach can be more comfortable for long term ventilated patients.

Dr. David :

because they don't have to have a tube down their throat.

JACUSTOMER-uxy5rcn8- :

we are trying to ascertain the best option

Dr. David :

good luck to you and him.

JACUSTOMER-uxy5rcn8- :

how long can he be sedated for

Dr. David :

let me know if you have other questions.

Dr. David :

as long as it takes to get his lungs better so he can breath on his own.

JACUSTOMER-uxy5rcn8- :

surely not for many months that tb meds would require

Dr. David :

usually 6-12 months of treatment.

Dr. David :

but his lungs should get better before then.

JACUSTOMER-uxy5rcn8- :

can he be sedated for that period of time

Dr. David :

no, he doesn't need to be sedated for the full 6-12 months.

JACUSTOMER-uxy5rcn8- :

that seems excessive (to me)

Dr. David :

just until his lungs are better to breath on his own.

JACUSTOMER-uxy5rcn8- :

ok thank you

Dr. David :

that is the length of TB treatment.

Dr. David :

you are welcome

Dr. David :

please leave positive feedback below when done

JACUSTOMER-uxy5rcn8- :

thank you

Dr. David :

we only get credit for helping clients after positive feedback.

Dr. David :

you might have to scroll down to see the ratings area below.

Dr. David :

thanks for using JustAnswer.com

Dr. David :

do you see the ratings area below?

JACUSTOMER-uxy5rcn8- :

yes

Dr. David :

thanks

Dr. David :

thanks

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44438
Experience: Board Certified Physician
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