For a patient with a tracheostomy experiencing disconnection of their T-piece, what should the respiratory therapist recommend?

• A. Sedate the patient
• B. Secure the T-piece with cotton ties
• C. Replace the T-piece with a tracheostomy collar
• D. Instruct the patient not to turn so often

Answer: (C)

When a patient with a tracheostomy experiences disconnection from their T-piece, it is crucial to restore an effective pathway for ventilation and oxygen delivery. Replacing the T-piece with a tracheostomy collar is the most appropriate action. A tracheostomy collar provides a stable and secure method to deliver humidified air, assisting in maintaining the patient’s airway and preventing potential complications such as hypoxia or respiratory distress.

While securing the T-piece with cotton ties might seem logical, it does not effectively address the immediate concern of maintaining ventilation and could lead to further disconnection if the ties are not secure or protective. Sedating the patient is unnecessary and could lead to complications, particularly if it impairs the patient’s ability to breathe adequately. Instructing the patient not to turn often does not solve the acute issue, as mobility is important for overall health and recovery.

Therefore, using a tracheostomy collar allows for continuous airflow and can help stabilize the patient's condition promptly.