TRACHE CARE Flashcards
What is a tracheotomy?
A surgical procedure in which an opening is made into the trachea.
What is a tracheostomy tube?
An indwelling tube inserted into the trachea for maintaining an open airway, which may be temporary or permanent.
What are key steps for patient care immediately after intubation?
Check chest expansion symmetry, auscultate breath sounds bilaterally, obtain capnography or end-tidal CO2, verify tube placement with chest x-ray, check cuff pressure every 6-8 hours, monitor for aspiration, ensure high humidity, administer prescribed oxygen concentration, secure the tube, and use sterile suction techniques.
What steps are involved in the extubation process?
Explain the procedure, have a self-inflating bag and mask ready, suction the tracheobronchial tree and oropharynx, deflate the cuff, give 100% oxygen for a few breaths, and remove the tube at peak inspiration while suctioning.
How should a patient be cared for following extubation?
Provide heated humidity and oxygen by facemask, maintain high-Fowler position, monitor respiratory rate and oxygen level, keep the patient NPO or provide only ice chips for a few hours, provide mouth care, and educate on coughing and deep-breathing exercises.
What are the main purposes of a tracheostomy?
To maintain a patent airway, bypass upper airway obstructions, facilitate secretion removal, permit long-term mechanical ventilation, decrease airway resistance, and prevent aspiration.
What are common indications for a tracheostomy?
Airway obstruction, congenital causes, and retained secretions in the trachea-bronchial tree.
What are contraindications for tracheostomy?
Laryngeal cancer, tracheo-esophageal fistula, and upper GI tract cancer.
What equipment is needed for tracheostomy insertion?
Tracheostomy tube, sterile blade, forceps, suture, scissors, gauze pad, antiseptic solution, sterile gown, gloves, shave prep kit, sedation, local anesthetic, resuscitation bag, and oxygen source.
What should be assessed in a patient with a tracheostomy?
Respiratory status (ease of breathing, rate, rhythm, depth, lung sounds, oxygen saturation), pulse rate, secretions at trach site, tracheostomy dressing drainage, and incision appearance.
What are early complications of a tracheostomy?
Tube dislodgement, accidental decannulation, bleeding, pneumothorax, air embolism, aspiration, subcutaneous or mediastinal emphysema, recurrent laryngeal nerve damage, and tracheal wall penetration.
What are long-term complications of a tracheostomy?
Airway obstruction, infection, innominate artery rupture, dysphagia, tracheoesophageal fistula, tracheal dilation, tracheal ischemia, necrosis, and tracheal stenosis after tube removal.
What are key care steps for a patient with a tracheostomy or ET tube?
Continuous monitoring and assessment, maintaining a patent airway with proper suctioning, positioning in semi-Fowler position, and cautious use of analgesia and sedatives.
What measures prevent complications associated with endotracheal and tracheostomy tubes?
Provide adequate warmed humidity, maintain cuff pressure, suction as needed, ensure skin integrity, change tape and dressing, auscultate lungs, monitor for infection, maintain hydration, and use sterile technique.
What is the importance of tracheostomy care?
To prevent infection, maintain an open airway, and prevent breathing complications.
