Professional Documents
Culture Documents
Tracheostomy
Tracheostomy
• in general, if extubation (ET) not possible, tracheotomy ○ Head, facial, or neck injury.
performed after 7 to
10 days for long-term ventilation • May cause trauma to the nasal passages.
7. Decrease work of breathing and increase volume entering
the lungs by reducing ○ Do not attempt to force the catheter
anatomical dead space if resistance is met.
• severe COPDhwlo
D. COMPLICATIONS ○ Report if significant bleeding occurs.
Immediate: • Insert a nasal airway if repeated suctioning is
• hemorrhage
necessary to protect the nasal passages from
• pneumothorax
trauma.
• subcutaneous and mediastinal emphysema
• respiratory and cardiovascular collapse • Be alert for signs of laryngeal edema due to
• dislodged tube irritation and trauma.
Late:
• airway obstruction (obstruction with secretions, ○ Stop if suctioning becomes difficult
constriction of airway by ties, or if the patient develops new upper
improper tube or placement, overinflated cuff) airway noise or obstruction.
• infection (nosocomial pulmonary infection rate in patient
with a trach is 50-66%; ○ Duration of the suctioning should be
largely due to natural body defenses being bypassed by the limited to less than 15 seconds.
trach tube; infection can
Suctioning Through an Endotracheal or Tracheostomy Tube
be pulmonary, stomal)
• aspiration (secretions, gastric contents)
• tracheal damage (progressive, fistula) • Ineffective coughing may cause secretion
• dislodged tube collection in the artificial airway or
Complications associated with suctioning: tracheobronchial tree, resulting in narrowing of
• hypoxemia → dysrhythmia, hypotension, cardiac arrest