Lauren from Boston Childrens:
Much sooner than we do
I say this due to the growing number of children with tracheostomy tubes that spent those 3+ months in the NICU with multiple reintubations or prolonged intubations that now need tracheal reconstruction.
I do hope our collegues from Neonatology and Otolaryngology do get together on this.
What i hear daily is " the parents arent ready" for trach and g tube. An infant with respiratory failure that will undergo tracheostomy for long term mechanical ventilation should in most cases have gastrostomy tube at the same time. Although many will be able to take some formula by mouth, breathing and eating do not typically come easy and are at a calorie cost.
There are cetainly comfort and developmental concerns as well with procedure delay.
I do believe it is our responsibility to present these necessary procedures to families as we do other medical procedures, life saving and therefor necessary
It would be great to have a national standard for consideration. Lauren