Breathing Problems

Breathing problems are often caused by injury to the brain stem or the motor cortex; these are areas that control our ability to breathe. Here is a resource about breathing complications that may occur after brain injury.

Breathing After Brain Injury
From Shepherd Center

What can be done to help support my loved one’s breathing?

There are treatments that can be done to improve your loved one’s respiratory function and support. Right after brain injury, the person with a DoC may have trouble breathing on their own so a breathing tube may be placed through their mouth, which is attached to a breathing machine called a ventilator.

What is a Tracheostomy?

A tracheostomy is a small surgical opening in a part of your throat called the trachea or windpipe. A tube (often called a trach) is placed into this hole to make it easier to breathe. Spaulding DOC Guide : page 28tracheostomy-in-adults-1.pdf (thoracic.org)
From the American Thoracic

How is a tracheostomy managed?

While in the hospital, your loved one will have a team of professionals who will manage your loved one’s tracheostomy, including. They may include pulmonologists, nurses, and/ or respiratory therapists. They will manage your loved one’s tracheostomy.

Tracheostomy Care
From Shepherd Center
 

What kinds of treatments are done for a tracheostomy? 

Your treatment team will provide the care while your loved one is are in the hospital. They also may train you as well.  Below are some links to some of the treatments.  Be sure to check with your treatment team prior to doing this yourself.
 
Suctioning
There are times when the muscles that help with breathing and coughing may not work well. A suctioning machine called an aspirator may be used to remove things like saliva and mucous that may cause your loved one to have trouble breathing. The suctioning machine is where a tube is used to suck the mucus from the lungs or saliva from the mouth. http://www.myshepherdconnection.org/respiratory/suctioning/sterile
 
In-Exsufflation
Use of an iIn-eExsufflator is another method used to clear the airway and lungs of mucous.  The iIn-eExsufflator is a machine about the size of a shoebox and is oftenbeing used in combination with suctioning in some places around the United States.  It can be used with a mask, mouthpiece, or directly on the trach tube. It works by using positive and negative pressure to create a "cough" that helps clear mucous with little or no discomfort.  https://www.myshepherdconnection.org/respiratory/in-exsufflator
 
Cleaning a tTrach
This is done regularly by clinicians to keep the trach clean to prevent infections. Your clinicians will show you how this is done so when.   When you go home, you it will be able to important to keep the trach clean to prevent infections as performedthey did in the hospital. Your treatment team will train you how to do this at home. Below is a website that helps you to understand how to do this.  https://www.myshepherdconnection.org/respiratory/tracheostomy-care
 
Trach humidification
Your doctor might order extra humidification to your trach based on the person with a DoC and how your loved one with DoCthey responded during the hospital stay.  This is for when your loved one needs humidification to thin out thick secretions or providegiving more humification to the upper airways. A doctor will order a trach collar for humidification. Your respiratory home care company will provide the supplies necessary for this setup. Below is a website that will help you to better understand how this works.
https://www.myshepherdconnection.org/respiratory/tracheostomy-care/humidification
 

Why is oral care important?

Oral care is important as it can minimize oral and respiratory infections.

This guide explains why oral care is important, what this care looks like, and what to do:
Oral Care Education, PDF 
From Memorial Hermann