Tracheostomy

Question 1

What are the reasons for tracheostomy being performed?

Answer 1

1 - Injuries to head and neck area

2 - Neuromuscular disorders

3 - Upper airway obstruction

4 - Bronchial toilet and secretion removal

Question 2

What are the basic features of a tracheostomy tube?

Answer 2

1 - Size of tube (diameter of inner tube)

2 - Cuffed (an inflattable baloon is inflated at the distal end of the tracheal tube to seal off the lumen against the outer rim of the tube) or un-cuffed

3 - Fenestrated (openings in tracheal tube that allow patient to speak) or non-fenestrated

4 - Single or double cannula

Question 3

How are tracheostomies cared for on a daily basis?

Answer 3

Daily checks - availability of spare and emergency equipment, cough effort, swallowing, sputum characteristics, inner cannula, tracheostomy tube and stoma

Humidification - to prevent secretions drying up

Clearing of secretions

Stoma care

Oral care and swallowing

Question 4

On what two places should tracheostomy patients receive oxygen?

Answer 4

Mouth

Over tracheostomy

Question 5

How is a tracheostomy blockage managed?

Answer 5

1 - Remove inner cannula

2 - Pass suction catheter down tracheostomy tube to assess tube patency and to clear any blockage

Question 6

If there is difficulty in passing the suction catheter through the tube, what does this suggest?

Answer 6

The tube has been displaced or is partially obstructed

Question 7

Once it has been established that there is a blockage, what should be assessed next?

Answer 7

Air movement throughout the tube