Tracheostomy care bitto
description
Transcript of Tracheostomy care bitto
TRACHEOSTOMY CARE
PREPARED BY:
BITTO BABY
BSN,RN
ANATOMY
Tracheostomy
It is a surgical opening in the anterior wall of the trachea just below the larynx.
INDICATIONS:-
To provide and maintain patent airway.
To enable the removal of tracheo-bronchial secretions.
To permit long term positive pressure ventilation.
To improve patient comfort.
To decrease the work of breathing and increase volume of air entering the lungs
TYPES OF TRACHEOSTOMY TUBES
Plastic or metal
Cuffed or uncuffed
Fenestrated or unfenestrated
Double canula or single canula
TYPES OF TRACHEOSTOMY TUBE
PLASTIC
METAL
TYPES OF TRACHEOSTOMY TUBES
CUFFED
UNCUFFED
TYPES OF TRACHEOSTOMY TUBE
FENESTRATED
UNFENESTRATED
TYPES OF TRACHEOSTOMY TUBES
SINGLE CANULA
DOUBLE CANULA
SHILEY CUFFLESS FENESTRATED TRACHEOSTOMY TUBE
ANATOMICAL POSITIONING OF TRACHEOSTOMY TUBE
COMPLICATIONS
Immediate1. Hemorrhage2. Hypoxia3. Trauma to recurrent laryngeal nerve4. Damage to esophagus5. Pneumothorax6. Infection7. Subcutaneous emphysema
COMPLICATIONS
Early
1. Tube obstruction or displacement
2. Pooling of secretions leading to aspiration and LRTI
3. Aspiration
4. Bleeding from tracheostomy site
5. Infection
COMPLICATIONS
Late1. Airway obstruction with aspiration2. Damage to larynx. Eg. Stenosis3. Tracheal stenosis4. Tracheomalacia5. Aspiration and pneumonia6. Fistula formation .eg. Tracheo-
cutaneous or tracheo-oesopheal
CARE OF THE PATIENT WITHTRACHEOSTOMY
Stoma care
1. Meticulous care towards hygiene and asepsis is necessary.
2. Remember the skin surrounding the stoma is also prone to irritation.
3. as per hospital policy}and barrier cream applied to the local skin{ cotton wool should be avoided}
CARE OF THE PATIENT WITH TRACHEOSTOMY
Tube care1. Tubes need to be cleaned.2. The area should be cleaned with normal
saline {In double cannula the inner cannula will need to be removed and to be cleaned. {Usually just with warm water and then left to air dry}
3. For cuffed tracheostomy tubes the pressure should be measured in every shift{ as per hospital policy}and maintained between 15-30cm of water.
CARE OF THE PATIENT WITH TRACHEOSTOMY
Suctioning
1. Suctioning should be done PRN ,after chest PT and Nebulization
2. Use the lowest pressure needed ,usually less than 120 mmHg and definitely not beyond 200mmHg.
3. Suctioning should be performed less than 10seconds.
CARE OF THE PATIENT WITH TRACHEOSTOMY
Humidification
1. The normal humidification and air filtration system is bypassed if the tracheostomy is in situ
2. Keep patients well hydrated- otherwise secretion will become thicker and will lead to infection.
THINGS TO REMEMBER
WHEN IN DOUBT CHANGE IT OUT
DON’T PANIC
STERILE TECHNIQUE
SAFTEY FIRST
CRITICAL THINKING
NUTRITION
COMMUNICATION
CARE….IT INSPIRES AND GENTLY REASSURES !!!!