''The nurse turned to us and told us it was down to us to make the tube that holds Summer's airway open....''

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Summer is a young baby living with PRS. At birth she didn't breathe for 8 minutes and had to be resuscitated and intubated in order for her to breathe.

Summer currently lives with a Nasal Pharyngeal Airway. This is an ivory tube cut to size and fitted through her nose and down to the end of her tongue. The NPA holds Summer's tongue forward to stop it from slipping back and completely closing her airway. 

Every few months Summer has a sleep study at Great Ormond Street Hospital for children. At our most recent sleep study they removed Summer's NPA. Summer coped really well for 8 hours without her NPA and even managed 3 hours totally tubeless. The Doctor soon revealed that Summer is still obstructing in her sleep therefore is still reliant on her prong. We were invited back in two weeks later for a follow up sleep study where they measured her growth then lengthened and widened the size of the tube. 

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I've put together a step by step of how I make Summer's breathing tube. One tube lasts one week then needs to be replaced. I usually make 4-5 at a time so I have enough incase she pulls them out or falls ill and it blocks.

 

If you'd have told me a year ago I would be sewing anything I wouldn't have believed you, it wasn't until the nurse turned to us and told us it was down to us to make the tube that holds Summer's airway open we knew we'd have to learn.

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                              Step 1

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                             LEFT-RIGHT: Stitches, Tracheal Tube, Tube holder.

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                                           Step 2

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                                Remove packaging making sure the tracheal tube & holder are

                                          the right size. Summer's new tube size is 4 and the holder is 3.5.

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                                Step 3:

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                                The tracheal tube is 4mm wide and its cut to 8.5cm long. The

                                          tube holder is a size 3.5 so it fits the tube snug. The length changes

                                          dependent on the size of the nostril and airway, the more growth the 

                                          longer and wider it needs to be to do its job.

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                               Step 4:

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                                Once the tracheal tube is cut to the exact size it should be, the

                                         tube holder needs to be attached and the first stitch can be sewn.

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                               Step 5:

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                                  The first loop you make has to be a double stitch so its extra

                                            strong. Every nurse and mother sew differently, I was taught

                                            to sew 4 stitches either side so its nice and secure. The stitches 

                                            hold the tube to the tube holder in order to be taped and secured

                                            with plasters onto Summer's cheeks.

                                            And actually me & Paul agree that its the stickers that make the

                                            tubes look more severe.

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                             Step 6:

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                                    Lastly, once the four stitches have been sewn on the first side

                                             the stitch has to be woven to the other side making sure you don't

                                             sew directly across blocking the tube opening. 10 stitches in total hold well.

                                             The very last stitch, like the first has to be a double stitch then

                                             look the thread in between the loop almost like a knot and cut away

                                             the rest of the thread. The tapes and plastered are only attached 

                                             when the tube is about to be fitted into Summer's nose. Everything

                                             has to be sterile so these are kept in a sterile bag until we need to

                                             use them.

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With 8 whole busy months worth of practise I can officially say making NPA's are weirdly quite therapeutic and are easier than I could of ever imagined.

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Thanks for reading Tube Making.

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Jessica x

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