Tracheostomy Care
PATIENT NAME ______SOC ______
INITIAL
Define a tracheostomy.
______A. It is an incision made into the trachea to create an airway.
______B. The opening is called a “stoma.”
______C. It can be permanent or temporary.
Describe a tracheostomy tube.
______A. The tracheostomy tube can be metal or plastic:
______1. The metal tube has an inner cannula.
______2. The plastic tube may or may not have an inner cannula.
______B. The tube may be cuffed or uncuffed.
Cleaning the inner cannula.
______A. Wash hands and put on sterile gloves.
______B. Cleanse around stoma with QTips dipped into hydrogen peroxide.
______C. Then rinse with normal saline soaked QTip.
______D. Dry with dry 4+4.
______E. Remove inner cannula and place in hydrogen peroxide and clean with a brush.
______F. Then rinse inner cannula with normal saline or water.
______G. Shake off excess fluid but do not dry.
______H. Suction the outer cannula, and then reinsert inner cannula and lock in place.
Changing tracheostomy ties.
______A. Always have two people for this procedure so that one person can hold the tube firmly in place while the other person changes the ties.
______B. Use 3/4 inch twill tape and tie with a square knot.
______C. Avoid tying knot over the carotid artery or spinal cord.
______D. Tie firmly but loose enough for two fingers to fit under the tape.
Skin care.
______A. Assess for signs and symptoms of infection, i.e., fever, redness, irritation, etc.
______B. Cleanse skin frequently and place a dry gauze around stoma.
______C. Apply ointment for protection if ordered.
Procedure to follow if trach tube accidently falls out.
______A. Remove inner cannula from dislodged tube.
______B. Insert obturator into the outer cannula and reinsert the tube.
______C. Remove the obturator and insert the inner cannula.
General precautions.
______A. Do not allow smoking in the same room.
______B. Avoid aerosol sprays and dust that may enter trach.
______C. Provide adequate humidification.
______D. Keep a suction machine at the bedside at all times.
______E. Perform suctioning as needed but avoid oversuctioning because it may increase secretions.
______F. Tape obturator to head of bed and keep an extra tracheostomy set and hemostat at the bedside.
______G. Prevent infection with good oral hygiene avoid persons with respiratory infections.
______H. Avoid getting any water into the stoma.
______I. Use other communication techniques if speaking is impaired (call bell, sign language, pictures, etc.).
______J. Cover the stoma loosely if going out into very cold weather.
______K. Drink at least 3000 ml of water per day unless contraindicated.
______L. Avoid smoking.
______M. Wear Medic Alert bracelet.
______N. Keep followup appointments with physician.
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