Tracheostomy Basics Flashcards
What is ostomy?
surgical opening
Why would a patient need a tracheostomy placed?
airway occlusion, facial trauma, inability to ventilate
What are reasons that patients may be unable to maintain their airway?
neurological disease/injury (stroke, guillan barre, coma), obesity (extreme sleep apnea, occlusion), or facial trauma
What are reasons that patients may not be able to oxygenate or maintain their airways?
critical illness (neurological conditions) (severe pulmonary conditions- i.e. COPD, emphysema, cystic fibrosis)
Why might a patient not be able to oxygenate, ventilate, or maintain an airway?
neurologic conditions (c-spine injury/quadriplegia) or critical illness (acute RF w/ long term MV)
Where in the hospital are tracheostomies performed?
bedside or in the operating room if the patient is too unstable or their anatomy is off
Where is information about the trach found?
on the trach plate (AKA Flange)
What information can be found about the trach on the trach plate?
size, fenestrated or on-fenestrated, cuffed or non-cuffed, disposable or non-disposable inner cannula
What is the benefit of having a fenestrated trach?
it allows air movement to go through and pass over the vocal cords
if a patient has a fenestrated inner cannula as well as a fenestrated trach, what does this allow the patient to do?
speak
What kind of inner cannula must be used in order to suction a trach?
non-fenestrated
What color is the hub of a fenestrated inner cannula?
green
How often should the RT be assessing the balloon pressure on a cuffed trach?
every shift and PRN
When is a cuffed trach necessary?
when mechanical ventilation is necessary
Why is a silicone plate used for a trach now?
it decreases the risk of pressure injury
What is used to anchor trachs?
Trach ties and sutures
When is a Passy muir valve used?
for stabilized patients that do not require MV and is ready for speech therapy, so that they can breath through the mouth and speak more normally
What emergency equipment must always be at the bedside for a trach patient?
extra tracheostomy set, ambu bag and mask, occlusive dressing, suction equipment, and an obturator from the original trach tube box
Where should the obturator be kept?
in biohazard bag taped to the HOB
