Short 🧵on the Shiley XLT...
Highlights
- Short 🧵on the Shiley XLT ('extended length') tracheostomy tube (or as I like to call it, the 'extra long trach'), which comes in 2 different types, and in particular a small but important feature of these tubes that has to be taken into account.
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- The Shiley XLT comes in sizes 5, 6, 7, and 8 and there are two kinds:
The more common 'proximal' XLT for patients with thick necks (L picture, top tube)
and the 'distal' XLT, for when you need a longer tube because there is an issue with the more proximal trachea (R pict)
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- Here is the end of a 'regular' 8 Shiley tube (currently called the '8CN85H', but usually we just say '8 Shiley'.
Note that the contour is relatively smooth, facilitating insertion (the 8PERC tube (not shown) is even better).
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- Now here is the end of the XLT with the obturator in place (both 'proximal' and 'distal' look the same).
Note that it is not smooth at all...there is quite a stepoff and insertion of this trach tube is noticeably more difficult.
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- Once the tube is in, the difference is a non-issue. At this point the main difference (other than it being 'extended length' is that the cuffs are the traditional type whereas the new Shiley tubes have a 'TaperGuard' cuff, which is supposed to confer certain advantages.
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- Just to reiterate, this stepoff makes these tubes technically more challenging to place (which was the entire point of this 🧵)
If anyone has any pointers, please let the rest of us know.
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- Going into all the intricacies of tracheostomy tubes would require many 🧵.
For those who are interested, this is a nice resource from UC Davis with a lot of detailed information.
https://t.co/QW0tzH1lYp. (View Tweet)