What are eight important safety measures when caring for the client with tracheostomy?
How can I stay safe with my tracheostomy?
What to do if you cannot breathe through the tracheostomy tube
If you still cannot breathe, put saline solution in your tracheostomy tube to cause a cough. Try to suction. If you still cannot breathe, put in the spare tracheostomy tube. Show
Call 911 if the tracheostomy tube cannot be put back in. Open Resources for Nursing (Open RN) Tracheostomy care is provided on a routine basis to keep the tracheostomy tube’s flange, inner cannula, and surrounding area clean to reduce the amount of bacteria entering the artificial airway and lungs. See Figure 22.9[1] for an image of a sterile tracheostomy care kit. Figure 22.9 Sterile Tracheostomy Care KitReplacing and Cleaning an Inner CannulaThe primary purpose of the inner cannula is to prevent tracheostomy tube obstruction. Many sources of obstruction can be prevented if the inner cannula is regularly cleaned and replaced. Some inner cannulas are designed to be disposable, while others are reusable for a number of days. Follow agency policy for inner cannula replacement or cleaning, but as a rule of thumb, inner cannula cleaning should be performed every 12-24 hours at a minimum. Cleaning may be needed more frequently depending on the type of equipment, the amount and thickness of secretions, and the patient’s ability to cough up the secretions. Changing the inner cannula may encourage the patient to cough and bring mucus out of the tracheostomy. For this reason, the inner cannula should be replaced prior to changing the tracheostomy dressing to prevent secretions from soiling the new dressing. If the inner cannula is disposable, no cleaning is required.[2] Checklist for Tracheostomy Care With a Reusable Inner CannulaUse the checklist below to review the steps for completion of “Tracheostomy Care.” Stoma site should be assessed and a clean dressing applied at least once per shift. Wet or soiled dressings should be changed immediately.[3] Follow agency policy regarding clearing the inner cannula; it should be inspected at least twice daily and cleaned as needed. StepsDisclaimer: Always review and follow agency policy regarding this specific skill.
Sample DocumentationSample Documentation of Expected FindingsTracheostomy care provided with sterile technique. Stoma site free of redness or drainage. Inner cannula cleaned and stoma dressing changed. Patient tolerated the procedure without difficulties. Sample Documentation of Unexpected FindingsTracheostomy care provided with sterile technique. Stoma site is erythematous, warm, and tender to palpation. Inner cannula cleaned and stoma dressing changed. Patient tolerated the procedure without difficulties. Dr. Smith notified of change in condition of stoma at 1315 and stated would assess the patient this afternoon. What safety precautions must the nurse take when caring for a client with a tracheostomy?Procedure. Clearly explain the procedure to the patient and their family/carer.. Perform hand hygiene.. Use a standard aseptic technique using non-touch technique.. Position the patient. ... . Perform hand hygiene and apply non-sterile gloves.. Remove fenestrated dressing from around stoma.. What are the nursing considerations in caring the tracheostomy tube?When caring for a patient with a tracheostomy, nursing care includes suctioning the patient, cleaning the skin around the stoma, providing oral hygiene, and assessing for complications. Normal functions of the upper airway include warming, filtering, and humidifying inspired air.
What factors are important when performing tracheostomy care?Before you do anything, assess the following for your patient:. Respiratory status (ease of breathing, rate, rhythm, depth, lung sounds, and oxygen saturation level). Pulse rate.. Secretions from the tracheostomy site (i.e. character and amount). Presence of drainage on tracheostomy dressing or ties.. What safety equipment is necessary at the bedside of every patient with a trach?Recommended paediatric bedside equipment:
Spare tracheostomy tube (same size) plus tapes. Half-size smaller tracheostomy tube plus tapes. Round-ended scissors. Spare tapes.
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