tracheostomy 2

Question 1

sub-glottic aspiration port

Answer 1

he outside of the tube to
just above the cuff A syringe
attached to the port can be used to remove
aspirated secretions and reduce the risk of
pneumonia. The amount
aspirated over a 24-hour period

Question 2

Fenestrated tubes

Answer 2

a single hole or multiple
holes in the arc of the inner and outer tube
to facilitate airflow up into the larynx, and
improve voice quality

Question 3

Tracheostomy care

Answer 3

routine and
emergency airway management, safe
decannulation, weaning and safe discharge into the community. The patient’s
airway requires close monitoring 24 hours

Question 4

Securing the tube

Answer 4

tracheostomy tube can be held in place
by several different methods. At initial
insertion, the tracheostomy will be held in
place by suture and, in addition, a collar or
twill ties may also be used.

Question 5

Securement devices should be checked

once a shift,

Answer 5

or more frequently, if a patient

is at risk of pulling on the collar/ties

Question 6

Inner-cannula care

Answer 6

double lumen tube is used, the
inner cannula should be removed and
cleaned every 2-4 hours depending on the
quantity and tenacity of secretions; if these
are copious, the inner cannula will require
more frequent checks and cleaning
Some inner cannulas are
single-use only and should be replaced at
each check

Question 7

Stoma care

Answer 7

toma site should be checked at
least once a day, or more frequently if
required, and this requires two nurses: one
to hold the tube and one to clean the stoma
site. The site should be cleaned using a tracheostomy wipe or with 0.9% sodium
chloride solution, and dried thoroughly. It
should be monitored for any signs of infection such as offensive-smelling exudate,
redness, pain and swelling

Question 8

Humidification

Answer 8

As air passes through the mouth and the
nose, it is warmed, filtered and moistened.
Breathing via a tracheostomy bypasses the
nose and mouth, so artificial humidification is crucial to keep the tracheostomy
tube patent;

Question 9

Suctioning

Answer 9

suction should only be used for patients
who are unable to clear their own secretions into their tracheostomy tube
It is essential to encourage patients to
cough and clear their own secretions.

Question 10

Suction how long and often?

Answer 10

should be given for no more
than 10 seconds to reduce the risk of
hypoxia, cardiac arrhythmia and bronchospasm/constriction.
ction should be given no more than
three times consecutively to reduce the
chance of hypoxia, cardiac arrhythmia,
pulmonary atelectasis, bronchoconstriction/spasm, elevated intracranial pressure

Question 11

Hydration tracheostomy

Answer 11

Hydration is an important part of tracheostomy care, as dehydration can result in
secretions becoming thick and dry,
increasing the risk of a blocked tube.

Question 12

majority of patients with a tracheostomy will be nil by mouth, and regular
mouth cared
with VAP and

Answer 12

is essential in preventing problems, such as mouth ulcers and oral thrush. Poor oral hygiene is also associate and daily use of 0.12% chlorhexidine gluconate mouthwash or gel is recommended