General Santos Doctors’ Medical School Foundation, Inc.

Bulaong Subdivision, Dadiangas West, General Santos City

Tel No.: (083) 302-3507, Telefax No.: (083) 552-9793

Objective Structured Clinical Examination checklist

(OSCE)

TRACHEOSTOMY CARE

Name: ______________________________
Date :______________
Time Started: ________________________ Time Ended
________

SKILLS Performed Not Remarks

Properly Performed

ASSESSMENT/PLANNING 2 0
1. Assess breathing pattern.
2. Listen to breath sounds.
3. Observe for infection.
4. Observe for hypoxia.
5. Assess the needs of the patient with a tracheostomy for
suctioning and cleaning.
6. Wash your hands.
7. Obtain the necessary equipment &
materials needed.
MATERIALS NEEDED:
 Tracheostomy tube (Shiley)
 Mask
 Sterile gloves
 Self-inflating breathing bag (AMBU bag)
 Sterile water
 Sterile suction catheter
 Sterile syringe
 Normal saline if saline is to be instilled
 Sterile gauze squares
 Eye protection
 Portable suction machine
 Suction trap, if a spectrum specimen is needed
IMPLEMENTATION
8. Identify the patient.
9. Provide Privacy.
10. Explain the procedure.
11. Establish a way communicating with tracheostomy
patient.
a12. Test the suction apparatus.
13. Place the patient on supine or in Mid- Fowler’s
position. Turn the patient’s head slightly toward you.
Place the unconscious patient in lateral position facing
you.
14. Put an eye protection and mask.
15. Prepare 5ml of sterile saline in a syringe
(remove needle for safety).
16. Open the sterile suction set and prepare the
equipment.
ü Place the drape from the kit or a clean towel
over the patient’s chest.
ü Most kits contain a pocket of solution, sterile
gloves, the sterile suction catheter and sterile
gauze squares. If the kit contains all of these
equipment, first put on gloves
ü Pour the saline into the basin. Hold the catheter
in your dominant hand.

17. Attach the breathing bag to the oxygen source and

prepare to ventilate the patient.
18. Attach the breathing bag to the tracheostomy tube
and provides three deep breaths coordinated with the
patient’s breathing pattern.
19. Instill normal saline into the tracheostomy.
20. Control the suction with your unsterile gloved
hand, while suctioning with your sterile hand.
ü Insert the catheter 4 to 5 inches into the
tracheostomy without occluding the part on the
suction catheters.
ü Apply the suction by closing the system. This
is done placing your thumb over the post or
side opening at the base of the catheter.
ü Apply suction for only 10 seconds
ü Withdraw the catheter rotating it gently while
you continue suctioning.
ü Rinse the catheter with sterile water or normal
saline
21. Provide ventilation immediately after the
suction catheter is removed.
22. Observe the patient for dyspnea after the
suction catheter is removed.
23. If hypoxia occurs, immediately provide
additional deep breaths of oxygen
24. Turn off the suction and listen for clear
breath sounds.
25. If breathing is not clear, repeat suctioning
method.
26. If breath sounds are clear, use the breathing
bag to provide 3 or 4 deep breaths of oxygen
27. Disconnect the catheter from the suction
tubing.
28. Grasp the cuff of the sterile glove and pull
the glove down over the used catheter.
29. Discard all disposable equipment.
30. Wash your hands.
31. Provide oral hygiene.
EVALUATION/DOCUMENTTION
32. Evaluate using the following criteria:
a. Tracheostomy tube in place.
b. Respiratory rate and depth normal
c. Breath sounds clear
d. Patient resting comfortably

Total Items : 32
Highest Score : 64

Scoring : _______ X 100

64

RD Grade : ___________

Clinical Instructor: ______________________________________