Tracheostomy Flashcards
artificial airway
inserted into pt who may or may not be breathing on own
- emergent or non emergent
pharyngeal airways
mouth/nose, for ppl who can breathe on own
- lower LOC need to be suctioned
- lower respiration drive bc loss of muscle tone
- usually short term
tracheal airway
unable to breath efficiently
- mechanical ventilation
- airway patency issues
endotracheal vs percutaneous
endo: intubated, always on ventilator
percut: going through skin, bypass all oral structures, maybe ventilated, maybe breathing on own
tracheostomy tube
plastic or metal tube that fits through a stoma in the neck
- most tube has outer cannula with attached flange and cuff and removable inner cannula
indications for trach
- acute airway obstruction
- airway protection (after surgery)
- facilitate secretion removal
- prolonged intubation
benefits for prolonged intubation using trach
- less damage to airway
- more comfortable
- allowed to eat
- mobility is improved (tube secure)
types of trachs
1) shiley: disposable and plastic
- disposable inner cannula, cuff and obturator
2) jackson: reusable inner cannula and metal typically
- reusable inner cannula, no cuff, obturator
obturator
used to insert trach like a guide wire
purpose of cuff
helps create snug fit in trachea which
- prevents aspiration
- helps ventilator give strong breaths
when are cuffs inflated
pt mechanically ventilated
inflation ordered by HCP
- should be deflated if pt is stable, always check during head to toe
process to deflate a cuff
suction oropharynx (mouth), deflate cuff, suction trachea
complications of prolonged/over inflated cuff
- increased mucosal pressures
- cause ischemia –> PIs
- mucosal erosion
communicating w trach
can use a Passy-Muir
- cuff deflated
- approved by HCP
- collab with SP, RT
dont use if pt in respiratory distress
how does a tube usually get dislodged/decannulation?
pt cough or during transportation
- tube dislodge: everything out
- decannulation: cannula out
