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Home > Patient Education Repository > 13028--Non-Indwelling Prosthesis Care and Troubleshooting

patient education : 13028--Non-Indwelling Prosthesis Care and Troubleshooting

How to care for trachesophageal voice prostheses (TEPs) that are placed and managed by the patient or caregiver. how to troubleshoot common problems. This handout is specific to non-indwelling prostheses - includes leaking, bleeding, trouble voicing and lost prosthesis

Handout File:

PDF document icon PE13028_eng_NONIndwellingProthesis.pdf — PDF document, 32 KB (33674 bytes)
  1. document content:

    PROSTHESIS CARE & TROUBLESHOOTING: Non-Indwelling Style

    WHAT SHOULD I DO IF MY PROSTHESIS IS LEAKING?

    First figure out where the leakage is coming from. Is it leaking around your prosthesis or is it leaking through your prosthesis?

    If it is leaking through your prosthesis, your prosthesis may be dirty or broken. It may be just time to replace it if it is old. If it is just dirty, clean it and then put it back in. Don’t forget to put your catheter or dilator into your puncture while you clean your prosthesis. Never leave your puncture tract empty. If the prosthesis continues to leak, insert a new or alternate prosthesis.

    If it is leaking through the prosthesis and your physician or speech pathologist typically changes your prosthesis, contact your physician or speech pathologist to make an appointment to get your prosthesis changed within a few days. Liquids are going into your lungs and this can cause pneumonia, so do not wait to make an appointment. Until you can get the prosthesis re-evaluated, you can either insert a your prosthesis plug if you have been trained to use one, or you may simply use a disposable cotton tipped swab (Q-tip) into the prosthesis to plug it while you eat and drink. Be careful not to drop the cotton tipped swab into your stoma. This will hold you over for a few days but is not a substitute for changing your prosthesis.

    If it is leaking around your prosthesis you may need to have your prosthesis re-sized. Contact your physician or speech pathologist as soon as possible. Do not wait too long, because liquids leaking into your stoma can cause pneumonia.

    WHAT SHOULD I DO IF I NOTICE BLEEDING FROM OR AROUND MY PROSTHESIS?

    A small amount of bleeding after placement of the prosthesis is nothing to be concerned about. However, if it continues to bleed for more than a few hours or if the bleeding is more than a slight trickle, contact your physician.

    WHAT SHOULD I DO IF MY PROSTHESIS COMES OUT? Do not panic!

    Where is the prosthesis?

    If the prosthesis fell into your stoma, bend over and try to cough it out. Often people are able to cough it up. If after a few tries you are not able to cough it up, put your catheter into the puncture site and tape the catheter to your neck. Continue to try to cough out the prosthesis. However, if you are not able to cough it up within the next 1 hour, call your physician.

    If you have the prosthesis, you can replace the prosthesis yourself using your insertion stick. If you have trouble doing this, put your red rubber catheter into the puncture several inches and tape the catheter to your neck. Never leave your puncture site empty because food, liquid, and saliva (spit) will leak through the puncture site into your lungs. Always have a catheter on hand in case of a situation such as this. Contact your speech pathologist or physician for an appointment to replace the prosthesis.

    “I can’t find my prosthesis…”

    If the prosthesis did not fall into your stoma: it may have been swallowed (pushed in) or accidentally removed (pulled/coughed out).  Just place the red rubber catheter into the puncture site several inches and tape it to your neck until you can get into the office to have your clinician replace the prosthesis. Never leave your puncture site empty because food, liquid, and saliva (spit) will leak through the puncture site into your lungs. Always have a catheter on hand in case of a situation such as this. You may insert a back-up prosthesis or contact the speech pathologist or physician for an appointment to replace the prosthesis.

    WHAT SHOULD I DO IF I CAN’T GET MY PROSTHESIS BACK IN?

    Try to put a catheter into the puncture site. Do not force the catheter into the puncture site. Do not attempt to eat or drink anything if you are unable to get a catheter into your puncture site, because food and liquid will/could go into your lungs. If you still find that you are unable to get the catheter into the puncture site, contact your physician or speech pathologist.

    WHAT SHOULD I DO IF I FIND THAT I CANNOT MAKE A VOICE?

    If your voice becomes very weak or quiet or you cannot make any voice at all, take out your voice prosthesis and wash it.

    Can you make a voice without the prosthesis in place?

    • If you can make a voice without the prosthesis in place, there is probably something wrong with the prosthesis. Try putting in a different prosthesis.

    • If you can’t make a voice with the prosthesis out, then there may be something wrong with your puncture (swollen, narrow, or closed).

    1. Try putting your catheter in the puncture site. Let the puncture tract dilate for a while, then attempt to re-insert your prosthesis.

    2. If you are still unable to make a voice, contact your physician or speech pathologist.

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