Trach Tube Change Flashcards
verifies physician’s order/facilities protocol
scans chart for pertinent data/notes
gathers equipment
same size, size smaller, water-soluble lubrication, syringe, suction supplies, trach care supplies
utilizes and maintains standard precaution
indentifies patient, introduces self, depart
explains the procedure
position patient in semi-fowlers with neck slightly extended
assesses pt.
HR, RR, BS, COLOR, ETC
assures pt. is properly oxygenated before & t/o procedure
hyperoxygenate as needed
suctions pt. removes dressing
performs modified trach care as needed (quick cleaning if needed)
ask helper to wash hands, don gloves, gives syringes to helper
opens outer package of tracheostomy tube, then the inner package maintaining it’s sterility, apply lube to sterile field
applies sterile gloves
removes inner cannula, place obturator into trach tube
helper inflates cuff, attaches second syringe to pt.’s old trach pilot balloon
lubricate distal portion of the trach tube & cuff while cuff is inflated
checks integrity (no holes)
helper deflates cuff (until resistance is met)
RESET SYRINGE TO 10 ML AND REATTACH TO NEW CUFF
HELPER DEFLATES PT.’S CUFF (until resistance is met)
helper removes old trach with instruction from RT
quickly assess stoma site and wipe if needed
insert new trach tube, remove obturator
CHECK FOR AIRFLOW
INFLATE CUFF, CHECK FOR AIRFLOW
put new inner cannula in
check for airflow
attach new ties, perform 1-2 finger check
APPLY NEW DRESSING
assess cuff pressure (20 - 30 cm H2O)
reassess pt.
RETURN FIO2 TO PREVIOUS SETTIG
