III.
II.
I.
Pediatric Tracheostomy
Rationale for Use: Blue Dye Testing
Step I
• Clinical evidence of
airway
contamination
Pediatric Tracheostomy
Rationale for Use: Blue Dye Testing
Step I
• affords us a means of obtaining a
clinical baseline in a young trached
patient who is:
• critical condition, critical airway
• has a tenuous airway, e.g.,
cranial nerve involvement,
copious secretions, etc.
• no oral feed experience
Pediatric Tracheostomy
Rationale for Use: Blue Dye Testing
Step I
• when Risks outweigh Benefits
• of a PO trial of food or liquid
• of either transporting &/or
undergoing a radiographic
procedure
Tracheostomy
Clinical Test for Aspiration
•
•
•
•
Blue Dye Test
(Initially describe by Cameron et al., 1973)
4 drops of 1% solution of Evan’s blue dye
Place the drops on the tongue q4hrs
Continue testing for 48 hours
Positive test:
• “any evidence of blue dye marker on
suctioning thru trach tube or ET tube”
Step I: Blue Dye to
Posterior Oral Tongue
• Pre-test suctioning of the oral cavity and the cannula
• Test Timeline: immediate
1.5 hours
• Observe closely the inner diameter of the hub
• Look for very pale green hue overtime
• Do NOT suction to check for blue dye
• If you must suction within the 1-1.5 hours of
observation, then consider this a “red flag”.
Videos removed
III.
II.
I.
Pediatric Tracheostomy
Rationale for Use: Blue Dye Testing
Step II
& III
• Clinical evidence of airway
contamination
Pediatric Tracheostomy
Rationale for Use: Blue Dye Testing
Step II
Step III
• Determine “readiness” &
“refusal” to feed while keeping
the baby’s airways and lungs as
“safe” as possible
• Determine if we can collect data
under fluoroscopy
– Pt.: WOL#4
– Videos removed
– Pt.: BG M. MOL#4
Pediatric Tracheostomy
Swallowing
Aside from blue dye, is there evidence
of penetration &/or aspiration
If negative blue dye test,
Then cannot exclude airway contamination
If positive blue dye test,
Then airway contamination
Wessley MOL#6
Slo Mo
Videos Removed
Realtime
Nadira YOL#1
N.G.: VFSS x2
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