Staff in nursing homes need to monitor tracheotomy residents-every day, every shift. Part of providing good tracheotomy care is literally listening to the patient's breathing. If fluid collects in a tracheotomy patient's airway, it needs to be suctioned out. Failure to suction tracheotomy patients can result in the patient asphyxiating.
Who really likes to think about sputum or mucus? Well, Thomas Sharon, R.N. at legalnurseconsultanttom.com points out that sputum color is an important factor to look at when evaluating the quality of breathing tube care. Breathing tubes such as tracheostomies and ventilators are a common medical medical conditions for nurisng home and long-term care residents.
Obviously, these medical condions require ongoing nursing care which is beyond the common knowledge of many nursing home residents and their families. As nurse Tom discusses in his recent post, nurses must reposition and clean the breathing tube in order to prevent infection and medical complications. There are many preventable medical complications in respiratory patients that may be easily identified by a family member or friend with common sense.
Nurse Tom points out that the color and consistency of the sputum is frequently indicative of the quality of nursing care and may be used to identify potiential medical complications such as infection or suffocation. Futher, the breathing noises are important to pay attention to as well, as congested raspy breathing noises usually demand immediate nursing attention.
Below is the chart from Nurse Tom's site, demonstrating how to identify respiratory problems from the color and consistency of secretions.
| Color | Consistency | Odor | Comment |
| Clear | Thin | None | Within normal limits |
| Clear | Thick | None | Within normal limits |
| White | Thin | None | Within normal limits |
| White | Thick | None | First sign of problem-might be due to dehydration |
| Yellow | Thick | None to slight | Upper respiratory infection-get the nurse and find out what the treatment plan is |
| Yellow to green | Thick | Slight | Infection is getting worse-the treatment plan is not working. Find out what they are doing about it |
| Cream colored | Thick | Moderate | This is purulence (pus) coming from the lungs. Ask the doctor if there is an infectious disease consultant on the case. If not, make a demand for one |
| Coffee colored | Thick and chunky | Foul | This is likely a dangerous deep lung infection with possible gangrene. Insist on a detailed explanation of the interventions |
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