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Indication of Tracheostomy

The document discusses tracheostomy, including: - Tracheostomy is a surgical opening into the trachea through the neck to allow air passage and aid breathing. - Tracheostomy care involves changing the inner tube, cleaning the site, and changing dressings. - Tracheostomy is indicated for severe chest trauma, foreign objects in the airway, breathing difficulties, or airway reconstruction after surgery.

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Binita Shakya
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92 views3 pages

Indication of Tracheostomy

The document discusses tracheostomy, including: - Tracheostomy is a surgical opening into the trachea through the neck to allow air passage and aid breathing. - Tracheostomy care involves changing the inner tube, cleaning the site, and changing dressings. - Tracheostomy is indicated for severe chest trauma, foreign objects in the airway, breathing difficulties, or airway reconstruction after surgery.

Uploaded by

Binita Shakya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Tracheostomy

• The surgical formation of an opening into the trachea through the neck especially to
allow the passage of air. A tracheostomy opens the airway and aids breathing.

• Tracheostomy care includes changing a tracheostomy inner tube, cleaning tracheostomy


site and changing dressing around the site

Indication of tracheostomy

• Severe chest trauma


• Foreign bodies in hypopharynx or larynx
• Laryngeal bronchitis
• Problems requiring ventilator support etc.
• Breathing difficulty caused by edema ,injury or pulmonary conditions
• Airway reconstruction following tracheal or laryngeal surgery
• Airway protection from secretions or food because of swallowing problems.

Purpose
• To maintain airway patency
• To prevent infection at the tracheostomy site
• To facilitate healing and prevent skin excoriation around tracheostomy care.
• To promote comfort.
• To assess condition of ostomy.

Procedure

1. Assess condition of stoma like redness, swelling, character of secretions, presence of


purulence or bleeding
2. Examine neck for subcutaneous emphysema evidenced by crepitus around the ostomy
site.
3. Explain procedure to the patient and teach means of communication such as eye blinking
or raising a finger to indicate pain or distress.
4. Assist patient to a fowlers position and place mackintosh
5. Wash hands thoroughly.
6. Assemble equipment’s,
a. Open the sterile tracheostomy kit, pour Hydrogen peroxide and sterile normal saline in
separate gallipots.
b. Open other sterile supplies as needed including sterile applicators, suction kit and
tracheostomy care kit
c. Put on face mask and eye shield.
7. Do sterile gloves. Place sterile towel on patient’s chest Maintains aseptic technique.
8. Unlock the inner cannula and remove it by gently pulling it out towards you in the line
with its curvature. Place the inner cannula in the bowl with hydrogen peroxide suction
Hydrogen peroxide moistens and loosens dried secretions
9. Remove the soiled tracheostomy dressing, discard the dressing and gloves.
10. Clean the flange of the tube using sterile applicators or gauze moistened with hydrogen
peroxide and then with normal saline. Use each applicator once only. Using the
applicator or gauze once only.
11. Clean the stoma tube with the gauze half strength hydrogen peroxide may be used.
Thoroughly rinse the cleaned area using gauze squares moistened with sterile normal
saline.
12. Dry the stoma tube with dry sterile gauze. An infected wound may be cleaned with gauze
saturated with an antiseptic solution, then dried. A thin layer of antibiotic ointment may
be applied to the stoma with a cotton swab.
13. Cleaning the inner cannula
· Remove the inner cannula from the soaking solution.
· Clean the lumen and entire cannula thoroughly using the brush.
· Rinse the cleaned cannula by rinsing it with sterile normal saline.
14. Replace the inner cannula and secure it in place
· Insert the inner cannula by grasping the outer
· Lock the cannula in place by turning the lock into position.
15. Apply sterile dressing.
Open and refold a 4*4 gauze dressing into a ‘V’ shape and place under the flange on the
tracheostomy tube. Do not cut gauze pieces.
Ensure that the tracheostomy tube is securely supported while applying dressing.

16. Change the tracheostomy ties.


• Leave the soiled tape in place until the new one is applied ·
• Grasp slit end of clean tape and pull it through opening on one side of the tracheostomy
tube.
• Pull the other end of the tape securely thoroughly the slit end of the tracheostomy tube
on the other side.
• Tie the tapes at the side to side of the neck in a square knot.
17. Document all relevant information in the chart.

References

• Subedi .S, A complete textbook of child health nursing (2017), 1st edition, Divya
Deurali Prakashan Pvt. Ltd.
• Shrestha .T, Essential child health nursing (2016), 2nd edition, Medhavi Publication
• https://www.slideshare.net/thanuja01/tracheostomy-care-125629267
• https://www.slideshare.net/HaiderMohammed6/tracheostomy-care-61737766

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