artificial airways, tracheotomy, tracheal suctioning Flashcards
types of artificial airways
- oropharyngeal and nasopharyngeal airway: don’t go into trachea
- endotracheal tube: foes into trachea
- tracheostomy tube
why would an artificial airway be used?
if some is not oxygenating well on their own
-placed to provide ventilation, remove secretions, bypass obstructions, and to help people breath
why would an endotracheal tube be used?
- emergency situations
- unconscious/semiconscious
- cannot breath on own
- lots of secretions
- allow for connection to ventilator
tracheostomy
-used to establish an airway via a tracheostomy
-advantages over endotracheal tube
-indications
replace ET tube and allow for mechanical ventilation
acure or chronic airway obstruction
copious secretions
what is the function of the obturator: tracheostomy
- helps to guide the placement
- the rounded tip at the end probes from the end of the cannula and prevents injury to the airway during placement
inner cannula of tracheosotmy
outer canula
Inner: may or may not be disposable
- helps keep the airway clean from secretions because it can be removed
outer: remain inlace in the trachea
2 types of tracheostomy
cuffed or cuffless
purpose of tracheostomy cuff?
creates seal to have effective ventilation: does not allow for leaking of oxygen
- holds the trachea in place to prevent damage to the mucosa/erosion
- prevents things from bypassing the epiglottis (which is help opened by the tracheostomy) and leaking into the lungs
should the cuff ever be deflated?
the cuff should be deflated.
if the cuff is never deflated the capillary will. be squeezed and will not refill
types of tracheostomy tubes
- single outer cannula
- double cannula: permanent inner/disposable inner
uncuffed tracheostomy tube
- minimal or no risk of aspiration
- no foreseeable need for mechanical ventilation
- used for patient in the community who have tracheostomies
care considerations for tracheostomies
- always look at agency policy
- secure the trachea: 2 people to change ties
- PPE: mask, face shield, eye wear, gown
- stoma care:
stoma care
-stoma dry and clean
-dressing clean and dry (sterile)
-pre cut non raveling dressing (lint can cause aspiration/irritation)
(dry to prevent infection)
preparation for emergency situations (tracheostomy)
accidental documentation equipment at bedside at all times: -obturator -suction equipment -oxygen -2 new tracheostomy's tubes (same size and one smaller) Bag valve mask
what to do if the patient was accidentally decannulated
- call for help: rapid response
- can use sutures to hotd site open
- lift head and tilt chin to get closer look at the stoma site
- listen to stoma site for subcutaneous emphysema
- use obturator and tracheostomy emergency either one size smaller, oxygenate the patient and monitor
- use obturator and outer cannula. to guide back in
- suction and provide oxygen `
