TRACHEOSTOMY CARE

Sumi Nath
Bsc. Nursing, MBA(HA), CCEPC
TRACHEOSTOMY

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 What is Tracheostomy?

A tracheostomy is an opening (made by an incision) through the neck

into the trachea (windpipe). A tracheostomy opens the airway and aids
breathing.

A tracheostomy may be done in an emergency, at the patient’s bedside

or in an operating room. Anesthesia (pain relief medication) may be
used before the procedure. Depending on the person’s condition, the
tracheostomy may be temporary or permanent.

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 • INDICATION OF TRACHEOSTOMY:-

• Obstruction of the mouth or throat

• Breathing difficulty caused by edema (swelling), injury or pulmonary (lung) conditions
• Airway reconstruction following tracheal or laryngeal surgery
• Airway protection from secretions or food because of swallowing problems
• Airway protection after head and neck surgery
• Long-term need for ventilator (breathing machine) support

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 WHEN TO CONTACT PHYSICIAN

 If patient have an irregular heart rate.

 If patient feel increased pain or discomfort.

 It is normal to feel some pain and discomfort for about a week after the tracheostomy procedure.

 If patient had difficulty in breathing and it is not relieved by usual method of clearing secretions.

 When secretions become thick, if crusting occurs or mucus plugs are present. .

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PARTS OF THE TRACHEOSTOMY TUBE

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PARTS OF TRACHEOSTOMY TUBE

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 ARTICLES FOR SUCTIONING
Assemble the following equipments for tracheostomy suction
 sterile sheet
 Sterile gloves
 Apron/Gown
 suction catheter
 Galipot
 Normal saline
 Sterile Gauze piece
 Knife Dish
 Suction apparatus
 Yellow Bag 9
 Assemble and check equipment
 Explain procedure to the patient
STEPS OF SUCTIONING
 Handwashing
 Wear Sterile Gloves and Gown
 Assess the Condition of stoma (redness, swelling, character of secreation, presence of purulence or bleeding)
 place sterilesheet on patients chest under tracheostomy site.
 insert suction catheter still resistence felt
 Suction the trachea and pharynx
 Reassess Patient
 Remove articles for after care
 Wash hands
 Documentation

Note: Check for adequate breath sound

Check Vital Signs & Oxygenation
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 Suctioning pressure

Negative pressure for suction apparatus

• Adult: 100- 120 mmhg pressure
• Paediatric: 80- 100 mmhg pressure

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TECHNIQUE OF SUCTIONING

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 ESSENTIAL PRINCIPLES FOR THE
 Infection Control TRACHEOSTOMY PATIENT

 Humidication

 Cuff Management

 Suctioning

 Management of Inner cannula

 Dressing

 Oral Hygiene

 Communication
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 Patient Anxiety HAZARDS OF SUCTIONING
 Changes in ICP

 Mucusal Trauma

 Infection

 Pneumothorax

 Sore throat

 Hypoxia

 Bradycardia

 Broncospasm 14
 COMMUNITY AND HOME CARE
CONSIDERATION
 Teach patient and caregiver procedure. Patient will need to use stationary mirror to visualize tracheostomy
and perform procedure.

 suctioning patient in the home: whenever possible, patient and caregiver should be taught to perform
procedure. Patient should use controlled cough and other secreation clearance technique.

 Need lots of reassurance and advice

 Teach patient about Stoma care and dressing change.

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FIXATION OF TRACHEOSTOMTY TUBE

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 THANK
YOU.......................................

TOGETHER WE CAN..........................

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