5.3 Treatment and intervention Flashcards
What are the things that we need to know about changing the tube post-surgery? (4)
- When: soiled, cuff rupture
- Avoid within week 1
- First time done by surgeon
- Difficult cases (obese, short or thick neck)
Post-surgery care also includes ___________, ___________ for inspired air, and management of ____________.
- Hygiene
- Humidification
- Secretions
What kind of care do we give to the patients? (3)
- Having a tracheostomy can be very traumatic and many patients find it difficult to adjust
- Patients with a new tracheostomy will need lots of support, reassurance and eduction
- Help family find alternate modes of communication
How often should a stoma be cleaned and inspected a day?
Cleaned/inspected 2-3 X/day
We have to ________ the process of stoma care to the patients.
Teach
We need to be careful to work ________ so that the _______ does not close.
- Quickly
- Stoma
Trach may prevent _________ movement of larynx during swallowing.
Upward
Between ____-___% of patients with a tracheostomy experience at least one episode of aspiration every 48 hours.
20-70%
__________ swallow evaluations are important.
Repeated
Feeding can be either _______ or _________
Oral
Nasogastric
What are the indications for suctioning? (6)
- Secretions in the trach
- Secretions in vocal trach
- Suspected aspiration
- Sustained coughing
- Respiratory distress
- If working on swallowing
What is the first step of suctioning?
Connect the catheter to the suction machine. Do not touch the end of the catheter that will go into the trach tube
What is the second step of suctioning?
Insert the catheter the proper distance into the trach tube (usually the length of the trach tube plus 1/4 inch)
What is the third step of suctioning? (2)
Apply suction by putting your thumb over the hole in the catheter while you gently pull the catheter out.
Gently roll the catheter between your thumb and forefinger as you pull the catheter.
Who is capable of doing the suctioning? (4)
- SLP
- Respiratory care practitioner
- Nurse
- Parents may also do this at home once the child is stable
How do you complete Oral/Nasal and Tracheal suctioning? (3)
- Insert tubing without any pressure
- Saline solution used between each attempt
- When pulling up and out, apply negative pressure through button (occlude proximal portion of suction)