Tracheotomy
Is the incision into the trachea to establish an airway
Tracheostomy
Is the temporary or permanent opening
This procedure is done under what?
General anesthesia
What are the benefits
The benefits are the tube inserted into the trachea bypasses the nose/mouth and allows immediate
- inspiration
- expiration
- removal of secretions
what are the many reason for a tracheostomy?
- ) Lung issues( cancer , dead space , heavy secretions)
- ) airway compromises ( foreign objects, laryngeal spasms, stenosis
- )infections
- )croups
- ) Burns to face
What are the benefits of the tracheostomy
- ) Patient can eat solid foods
- ) Patient can talk of the cuff is deflated
- ) less damage to the airways
- ) no tube in the mouth
- ) trach tube is more secure
Safety tips about the parts of a trach:
Fenestrated inner cannula can not be used with __?
If the patients requires Mechanical ventilation, then a _______must be used
If the cuff is inflated then the patient would not be able to_____?
It should only be inflated if ____?
Mechanical ventilation
If the patients requires Mechanical ventilation, then a non- fenestrated inner cannula must be used
If the cuff is inflated then the patient would not be able to breathe through mouth or nose .
It should only be inflated if mechanical ventilation is in place
What does the decannulation plug do?
It is used for ?
If the patient experiences respiratory distress while the plug is on what do you do?
They decannulation plugs blocks air passing through the trach to allow the patient to breathe normally through the mouth and nose
It is used to for weaning
If the patient experiences respiratory distress while the plug is on what do you do?
Always keep an _____ at the bedside ( taped tot the wall) for emergencies?
Keep a _______ tube at the bedside ?
Who does the first tube/ dressing change?
If a tube is dislodge , The nurse you immediately ?The tube is inserted a ____ angle into the neck.
Once in insertion is complete, what do you do ?.
If the tube insertion is unsuccessful what do you do ?
Always keep an obturator at the bedside ( taped tot the wall) for emergencies.
Keep a replacement tube at the bedside
The physician does the first tube/ dressing change.
If a tube is dislodge , The nurse you immediately insert the obturator into the replacement tube And apply a water soluble lubricant; The tube is inserted a 45° angle into the neck.
Once in insertion is complete, remove the obturator. .
If the tube insertion is unsuccessful, manually ventilate the patient with AN ambu and to help arrives.
Place a patient in a semi Fowler‘s position as well
Tracheostomy suctioning (17 steps)
- ) Assess the client for need for suctioning
- ) Wash hands
- ) gather equipment: suction kit (Catheter, basin, gloves) suction apparatus, eye protection and sterile saline
- ) explain procedure to client. Apply Eye protection. Test suction apparatus.
- ) Open suction kit and Don gloves
- ) Pour saline into container
- ) attach catheter to suction tube
- ) wrap Catheter in hand to maintain sterility while you turn on suction equipment
- ) lubricant the catheter with saline
- ) Have assistant instill 5 cc sterile normal saline into the trach on inspiration
- ) Have Assistant hyperoxygenate lungs with 100% via self inflating breathing (Ambu bag) (2-3 times as client inhales) prior to suctioning because suctioning decrease oxygenation
- ) Without applying suction, insert Cather about 6 inches or until client coughs
- ) Upon stimulation of cough reflex, apply suction intermittently and slowly rotate the catheter between dominant Thumb and forefinger is the Catheter is withdrawn ( within 10 sec)
- ) assess apical pulse and breath sounds
- )! Repeat steps 12 and 13 based on assessment; limit suctioning to 3 passes of Catheter
- ) assistant should hyperoxygenate client between each suction pass.
- ) Discard equipment, wash hands and documents procedures
