Tracheostomy - PowerPoint Presentation

Slide1

Tracheostomy care

Presented by,Mrs.Starina Flower, M.Sc (N)Asst. Professor, Medical Surgical Nursing Department,Annammal College Of Nursing, Kuzhithurai. Slide2

ANATOMYSlide3

TERMS

Tracheotomy: Incision made below the cricoid cartilage through the 2nd-4th tracheal rings Tracheostomy: the opening or stoma made by this incision Tracheostomy Tube: Artificial airway inserted into the

tracheaSlide4

DEFINITION

The word “tracheostomy” is derived from the Latin word “trachea” and “tomein” (to make an opening).

Tracheostomy is an operative procedure that creates a surgical airway in the cervical trachea

The surgical placement of a plastic or metal tube into the trachea to create an airway. Slide5

TRACHEOSTOMY INDICATIONS

TO BYPASS OBSTRUCTION Tumors (oropharynx,larynx,upper trachea)Infections(epiglottitis,severe tracheobronchitis)

Bilateral vocal cord paralysis)

Trauma(

laryngeal,facial

fractures)

Edema(

tongue,larynopharynx

)

Intubation failure

Foreign body obstructionSlide6

TRACHEOSTOMY INDICATIONS

PROLONGED INTUBATION Neuromuscular diseases Paralyzing or weakening of chest muscles and diaphragmCervical spinal cord injuries with respiratory muscles paralysis Slide7

TYPES

OF TRACHEOSTOMY TUBEUncuffedCuffed

FenestratedSlide8

PARTS OF TRACHEOSTOMY TUBE

flange

Outer cannula

Inflation line

cuff

Pilot

ballonSlide9

Flange

- secured with tracheostomy tiesOuter Cannula -tube connected to flangeInner Cannula - removable for cleaningCuff -soft balloon around the end of the tube that can be inflated to allow for mechanical ventilationObturator

-

a plastic guide with a smooth rounded

tip

that is used to guide the outer cannula during

insertion

PARTS OF TRACHEOSTOMY TUBESlide10

Cuffed

Tracheostomy tubeIncrease or improve ventilation/oxygenationPrevent aspiration with feeding tubes, decreased gag reflex & gastro-esophageal refluxUn-cuffed Tracheostomy tubePlastic or metal tube

Allows air to flow freely around the

tracheostomy tube

through the larynx

Reduces the risk of tracheal

damage

Damage

Slide11

Fenestrated

Tracheostomy tube Permits speech through the upper airway when the external opening is corked and the cuff is deflated Restores more of a normal airflow by allowing air to pass up and down the airway from the nose & mouth Allows secretions to be coughed out through mouthInner Cannula Allows maintenance of tube patency Changing or cleaning the inner cannula helps to clear secretions

Can be non-disposable or disposableSlide12

EQUIPMENT FOR TRACHEOSTOMY CARE

Functioning Suction Suction catheters O2 for humidityAmbu bag Tracheostomy set of same size and type Sterile gloves

Disposable inner cannulas or

tracheostomy care tray for cleaning non-disposable

Normal

saline

Hydrogen peroxide (for non-disposable inner cannulas cleaning

)

Sterile 4X4 gauze pad

for dressing

change

Twill tapesSlide13

Verify physician order

Wash handExplain the procedureSuction prior to careOxygenate the patientRemove soiled dressingsDiscard the gloves usedOpen sterile tray.Pour normal saline into one bowl & hydrogen peroxide in another Don sterile glovesUnlock inner cannula and remove it. Soak inner cannula in hydrogenperoxide. Clean lumen and sides of inner cannula using sterile brush

cont

…..

PROCEDURESlide14

Rinse

inner cannula in normal saline and replace it.Change dressing under the tracheostomy tube.Clean stoma and area around outer cannula in circular motionPlace dry sterile precut gauze piece around tracheostomy stoma and under flangeChange tracheostomy ties if needed. Bring both ties at one side of the clientUse two square knots to secure ties.Remove gloves and discard disposablesAssist patient to comfortable positionOffer oral hygiene

Wash hands

Document the procedureSlide15

Complications

Early complicationsBleedingAir trapped around lungsTrauma to oesophagusInjuries to vocal cordsLater complicationsAccidental removalInfectionErosion of tracheaNarrowing of airway, blocked tubeSlide16