Tracheostomy

Question 1

 Cuff will be inflated to keep the tube in place for it not to be removed or accidentally cough out.
 Secure the tube in the trachea
 Pressure should be between 20-25mmhg to achieve on air seal.
 Increase greater pressure compresses the blood vessel -> Decrease blood supply -> Death of Tissue
 Decrease pressure ! Increase risk of aspiration
 Obturator guides in inserting the inner cannula
o Wash and dry thoroughly after removing

Answer 1

TRACHEOSTOMY

Question 2

INDICATIONS FOR TRACHEOSTOMY

Answer 2

❖ Prolonged Mechanical Ventlator (2-3 Weeks)
❖ Inability to clear lower tracheobronchial secretions
❖ Increased risk of aspirating gastric contents.
➢ The patient’s mouth and trachea should be suctioned before the cuff is deflated to prevent aspiration of oral secretions.
➢ The cuff is deflated during patient exhalation so that secretions will be forced into the mouth rather than aspirated.

Question 3

INDICATION FOR SUCTIONING

Answer 3

 Coughing
 Secretions in the airway (Auscultate)
 Respiratory Distress (The patient is having a
 hard time breathing)
 Decrease oxygen saturation.

Question 4

SUCTION THE PATIENT WITH TRACHEOSTOMY

Answer 4

➢ Put on mask, goggles, face mask
 Keep the suction regulated at 80-120mmhg to prevent injury of the lungs
 Use sterile gloves

➢ Maintain Humidification
 Increasing fluid intake to loosen secretions
 If patient is unconscious give water or regulate IV.
 To remove easily the secretions

➢ SUCTION PRESSURE
 No greater than 120mmhg of suction for it decreases o2 in the body layers:
▪ Hypoxemia
▪ Atelectasis
▪ Airway trauma

➢ The patient’s mouth and trachea should be suctioned before the cuff is deflated to prevent aspiration

➢ The cuff is deflated during patient’s exhalation so that secretions will be forced into the mouth rather than aspirated

➢ There is no need to clean the inner cannula before cuff deflation

➢ ORAL HYGIENE to increase salivation
 Brushing the patients teeth, tongue and gums
 Rinse the patients mouth with CHLORHEXIDINE BID for 30seconds
 Lemon Swab
 Deep oropharyngeal suctioning to remove any secretions that have pooled the cuff.
 Remove the old dressing with clean gloves
 Wash hands
 With sterile swab moistened
 Inward to outward