TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

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Tracheostomy care

Tracheostomy care

Definition :

Tracheostomy is surgical procedure in which opening is made into the trachea.

-Tracheostomy may be either temporary or permanent.

-The surgical procedure is usually preformed in the operating room or ICU.

-A surgical opening is made in the 2^nd and 3^rd tracheal ring .

-Cuffed tracheostomy tube of appropriate size is inserted.

TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

Purposes :

1- To bypass upper airway obstruction.

2- To allow removal of tracheobronical secretions.

3- To allow long term use of mechanical ventilation.

4-To prevent aspiration of oral or gastric secretions in paralyzed patient.

5- To replaced endotracheal tube.

The cuff is inflatable attachment to the tracheostomy tube :

1-To occlude the space between the trachea walls & the tube.

2- to permit effective mechanical ventliation.

3- to minimize the risk of aspiration.

TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

Aisha Alhofaian

Equipment :

Tracheostomy care kit : Hydrogen peroxide

Sterile towel Sterile water

Sterile gauze sponges (12) Antiseptic solution

Track sparks (2) Tracheostomy tie tape

Face shield

Sterile cotton swabs

Sterile gloves

Procedure guidelines :

Nursing action Rationale

Preparatory phase

1- Assess condition of stoma . 1- The presence of skin breakdown or infection must be monitored .

2- Examine neck for subcutaneous 2- Indicates of air leak

Emphysema in subcutaneous tissue.

Performance phase

1- Explain procedure for patient .

2- Wash hands.

3- Suctioning of the trachea. 3- To remove the secretion to keep the area clean .

4- Assembling and preparing equipment. 4- To maintaining sterile field.

- To removal of mucus and crust - open 2 sponges and pour hydrogen peroxide.

- open 2 sponges and pour antiseptic solution .

- open 2 gauze sponges ; keep dry .

- open 2 gauze sponges and pour sterile water .

- place sterile towel on patient chest .

- place tracheostomy tube tapes on field .

Aisha Alhofaian

TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

Procedure guidelines continued :

Nursing action Rationale

5- Wear sterile gloves and face shield. 5- Face shield to protect nurses eyes, sterile gloves to protect the

wound from contamination .

6- Cleanse stoma area and the plate of the 6- H2O2 help to loosen dry crusted.

tracheostomy tube with sterile cotton tipped

applicator or gauze saturated with H2O2.

TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

7- Repeat steps 6 using the sterile 7- To removed H2O2.

water-soaked gauze sponges.

8- Repeat steps 6 using dry sponges. 8- To dryness of the area .

9- Removing inner cannula by rotating 9- Because cannula is dirty .

it while stabilizing outer cannula for

cleaning with H2O2 and replacing

new disposable inner cannula.

10- Change tracheostomy tie. 10- To stabilize the tube and prevent accidental dislodgment and keep coughing

due to minimal manipulation .

Aisha Alhofaian

Procedure guidelines continued :

Nursing action Rationale

11- Place a gauze pad between 11- To absorb secretion and prevent irritation.

the stoma and tracheostomy.

TRACHEOSTOMY CARE DEFINITION TRACHEOSTOMY IS SURGICAL PROCEDURE IN

Follow up phase

1- Document procedure performance , 1- Provides a baseline .

observation of stoma [ irritation , reddness ,

edema, subcutaneous air] and character

of secretion [ color ,consistency].

2-Clean the stoma q8hrs or more 2- To prevent infection when the area clean

and tie should be changed every

24 hrs or more if soiled or wet.

References :

1-Suzanne C.Semltzer,Brenda G.bare,(2004).medical surgical nursing ( 10^th edition) .

2- Lippincott Williams & Wilkins, ( 2006 ), Manual nursing practice ( 8^th edition ).

Aisha Alhofaian

Tags: tracheostomy care, change tracheostomy, tracheostomy, surgical, definition, procedure