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  • Tracheotomy Care

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    Sachin Singh
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    Tracheostomy care involves cleaning the tracheostomy site and tube to maintain an open airway and prevent infection. It requires assembling sterile supplies and equipment, suctioning and cleaning the tube, stoma site, and inner cannula if present. Dressings are then applied and ties changed before documenting the procedure. Proper tracheostomy care is important for patient comfort and healing in critical care settings.

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    care of tracheotomy patient

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    tracheotomy care

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    Tracheostomy care involves cleaning the tracheostomy site and tube to maintain an open airway and prevent infection. It requires assembling sterile supplies and equipment, suctioning and cleaning the tube, stoma site, and inner cannula if present. Dressings are then applied and ties changed before documenting the procedure. Proper tracheostomy care is important for patient comfort and healing in critical care settings.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    898 views20 pages

    Tracheotomy Care

    Uploaded by

    Sachin Singh
    Tracheostomy care involves cleaning the tracheostomy site and tube to maintain an open airway and prevent infection. It requires assembling sterile supplies and equipment, suctioning and cleaning the tube, stoma site, and inner cannula if present. Dressings are then applied and ties changed before documenting the procedure. Proper tracheostomy care is important for patient comfort and healing in critical care settings.

    Copyright:

    © All Rights Reserved
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    DEMONSTRATION

    Tracheostomy care
    Definition-
     Tracheostomy care includes changing a
    tracheostomy inner tube, cleaning
    tracheostomy site and changing dressing
    around the site.
    Purposes-
     To maintain airway patency.
     To prevent infection at the tracheostomy
    site.
     To facilitate healing and prevent skin
    excoriation around the tracheostomy site.
     To promote comfort.
     To assess condition of ostomy.
    Equipment-
     Tracheostomy care kit containing:
     Gallipots (3).
     Sterile towel.
     Sterile nylon brush / tube brush.
     Sterile gauze squares.
     Cotton twill ties or tracheostomy tie tapes.
     Sterile bowl for solution.
    A clean tray containing:
     Sterile suction catheter.
     Hydrogen peroxide.
     Normal saline.
     Sterile gloves 2 pairs.
     Clean scissors.
     Face mask and eye shield.
     K basin.
     Waterproof pad.
    Nursing action-
     Assess condition of stoma: (Redness,
    swelling, character of secretions, presence
    of prudence or bleeding).
     Examine neck for subcutaneous
    emphysema evidenced by credit us
    around the ostomy site.
     Explain procedure to the patient and teach
    means of communication such as eye
    blinking or raising a finger to indicate pain
    or distress.
     Assist patient to a fowler’s position and
    place waterproof pad on chest.
     Wash hands thoroughly.
     Assemble equipment’s.
     Open the sterile tracheostomy kit, pour
    hydrogen peroxide and sterile normal saline in
    separate gallipots.
     Open other sterile supplies as needed
    including sterile applicators, suction kit and
    tracheostomy care kit .
     Put on face mask and eye shield.
     Don sterile gloves. Place sterile towel on
    patient’s chest.
     Suction the full length of tracheostomy
    tube and pharynx thoroughly.
     Rinse the suction catheter and discard it.
     Unlock the inner cannula if present and
    remove it by gently pulling it out towards
    you in line with its curvature. Place the
    inner cannula in the bowl with hydrogen
    peroxide solution (Applicable for tubes
    having inner and outer cannula).
     Remove the soiled tracheostomy dressing,
    discard the dressing and gloves.
     Don a second pair of sterile gloves.
     Clean the flange of the tube using sterile
    application or gauze moistened with
    hydrogen peroxide and then with normal
    saline. Use each applicator once only.
     Clean the stoma area with gauze (make
    only a single sweep with each gauze
    sponge before discarding).
     Halfstrength hydrogen peroxide may be
    used.
     Thoroughly cleanse the area using gauze
    squares moistened with sterile normal saline.
     Dry the stoma with dry sterile gauze.
     An infected wound may be cleaned with
    gauze saturated with an antiseptic
    solution, then dried.
     Cleaning the inner cannula
     Remove the inner cannula from the soaking
    solution.
     Clean the lumen and entire cannula
    thoroughly using the brush.
     Rinse the cleaned cannula by rinsing it with
    sterile normal saline.
     Gently tap the cannula against the inside of
    the sterile saline container after rinsing.
     Replace the inner cannula and secure it in
    place:
     Insert the inner cannula by grasping the outer
    flange and pushing in the direction of its
    curvature.
     Lock the cannula in place by turning the lock
    into position.
     Apply sterile dressing:
     Open and resold a 4×4 gauze dressing into a
    ‘V’ shape and place under the flange of the

    tracheostomy tube.
     Do not cut gauze pieces.
     Ensure that the tracheostomy tube is securely
    supported while applying dressing.
     Change the tracheostomy ties:
     Leave the soiled tape in place until the new
    one is applied.
     Cut a piece of tape that is twice the neck
    circumference plus 10 cm. Cut the ends of
    tape diagonally.
     Apply the new tape.
     Remove old tape care fully.
     Method of folding gauze square for
    placement under face plate.
     Grasp slit end of clean tape and pull it through
    opening on one side of the tracheostomy
    tube.
     Pull the other end of the tape securely
    through the slit end of the tracheostomy tube
    on the other side.
     Changing tracheostomy ties/tapes.
     Tie the tapes at the side of the neck in a
    square knot.
     Alternate knot from side to side each time
    tapes are changed.
     Tie should be tight enough to keep tube
    securely in the stomach, and loose enough to
    permit two fingers to fit between the tape and
    neck.
     Document all relevant information in the
    chart:
     Sectioningdone.
     Tracheostomy care carried out.
     Dressing changed.
     Observations.
    SPECIAL CONSIDERATION-
     Tracheostomy dressing should be done every
    8 hours or whenever dressings are soiled.
     Tracheostomy tubes may come with
    disposable inner cannula or without the inner
    cannula. If disposable inner cannula is
    present then replace the one that is inside
    with a new one.
     If only single lumen is present, then suction
    the tracheostomy tube and clean the neck
    plate and tracheostomy site.
    Conclusion-
     Tracheostomy care is very necessary in
    the critical care unit. If the nurses are not
    aware about this then it will create more
    problem to the patient.

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