trach care and suctioning Flashcards
what is a tracheotomy
long term air support
tracheotomy is the opening made for the tube itself
tracheotomy tube
is the tube itself that is inserted to extend thru the stoma into the trachea
equipment
trach tube
obturator
inner cannula
cuffed trac tubes
airtight seal
seals prevent air leakage
ess when mech suctioning
client asses
Respiratory status ease of breathing RR Resp Rhythm O2 saturation HR secretions drainage on trach dressing Appearance of incision
trach care
Suctioning (if required) Removing soiled trach dressing Cleaning around stoma Cleaning / changing the inner cannula Replacing the trach ties
potential complications for trachs
inability to remove secretions
infection
contaminating clean area with dirty dressing
improper rinsing of cleaning solution
failure to remove excess solution/failure to lock canula
complications/risk factors
cotton lint or gauze can be aspirated
excessive movement of trac can cause irritation
failure to tie the straps which causes loosening or shifting
dislodgement of trach
knot (maybe due to swelling) maybe too tight causing pressure and irritation
types of suctioning
oropharngeal nasopharngeal orotracheal nasotraceal tracheal
symptoms for suctioning
PRN respiratory distress SOB coughing low o2 sat cyanosis increased RR audible crackles
complications of suctioning
worsening respirtory status
bloody secretions
coughing
no secretions
techniques to decreases complications
hyperinflation
hyper oxygenation
To avoid trauma to trach
Apply suction intermittently only as the catheter is withdrawn.
never apply suction pressure while inserting the catheter,
maintain suction pressure less than 150 mm Hg in adults
open method of suctioning
open suctioning involves sterile cathered thagt is opened at the time of suctioning
sterile gloves are worn to perform this tasks
closed suctioning
involves multiple use suction cathered encased in a plastic sheath
Closed suctioning is most often used on patients who require mechanical ventilation to support their respiratory efforts, because it permits continuous delivery of oxygen
while suction is performed, thus reducing the risk of oxygen desaturation
oral airways
The oral airway, the simplest type of artificial airway, prevents obstruction of the trachea by displacement of the tongue into the oropharynx
The oral airway extends from the teeth to the oropharynx, maintaining the tongue in the normal position.
oral airways sizing
Proper oral airway size is determined by measuring the distance from the corner of the mouth to the angle of the jaw just below the ear.
oral airway sizing complications
If the airway is too small, the tongue is not held in the anterior portion of the mouth
if the airway is too large, it may force the tongue toward the epiglottis and obstruct the airway.
artificial airway
An artificial airway is for a patient with decreased level of consciousness or airway obstruction and aids in removal of tracheal bronchial secretions.
techniques for good lung expansion and lung expansion
positioning
ambulation
incentive spirotermoy
chest tubes
chest tubes
a cathered inserted into the thorax that drains fluid or air
Chest tubes are commonly used after chest surgery and chest trauma and for pneumothorax or hemothorax to promote lung re-expansion
mediastinal chest tube
is commonly used following open heart surgery. It is inserted in the mediastinum (below the sternum) and is connected to a drainage system.
pneumothorax
is a collection of air in the pleural space. The loss of negative intrapleural pressure causes the lung to collapse.
hemothorax
accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleurae, usually as a result of trauma. It produces a counterpressure and prevents the lung from full expansion
single chamber drainage sys
single-chamber system allows air from a pneumothorax to bubble out of the water seal and escape through the air outlet, preventing air from re-entering the intrapleural space
A two- or three-chamber system
drains both a hemothorax and a pneumothorax. The two-chamber system allows fluid to flow into a collection chamber and air to flow into the water seal chamber
A three-chamber system permits the drainage of fluid and air through controlled suction
The two- and three-chamber systems have two compartments—one for fluid or blood and a second for a water seal or a one-way valve
