artificial airways, tracheotomy, tracheal suctioning Flashcards Preview

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Flashcards in artificial airways, tracheotomy, tracheal suctioning Deck (22)
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1

types of artificial airways

-oropharyngeal and nasopharyngeal airway: don't go into trachea
-endotracheal tube: foes into trachea
-tracheostomy tube

2

why would an artificial airway be used?

if some is not oxygenating well on their own
-placed to provide ventilation, remove secretions, bypass obstructions, and to help people breath

3

why would an endotracheal tube be used?

-emergency situations
-unconscious/semiconscious
-cannot breath on own
-lots of secretions
-allow for connection to ventilator

4

tracheostomy

-used to establish an airway via a tracheostomy
-advantages over endotracheal tube
-indications
replace ET tube and allow for mechanical ventilation
acure or chronic airway obstruction
copious secretions

5

what is the function of the obturator: tracheostomy

-helps to guide the placement
-the rounded tip at the end probes from the end of the cannula and prevents injury to the airway during placement

6

inner cannula of tracheosotmy

outer canula

Inner: may or may not be disposable
-helps keep the airway clean from secretions because it can be removed
outer: remain inlace in the trachea

7

2 types of tracheostomy

cuffed or cuffless

8

purpose of tracheostomy cuff?

creates seal to have effective ventilation: does not allow for leaking of oxygen
-holds the trachea in place to prevent damage to the mucosa/erosion
-prevents things from bypassing the epiglottis (which is help opened by the tracheostomy) and leaking into the lungs

9

should the cuff ever be deflated?

the cuff should be deflated.
if the cuff is never deflated the capillary will. be squeezed and will not refill

10

types of tracheostomy tubes

-single outer cannula
-double cannula: permanent inner/disposable inner

11

uncuffed tracheostomy tube

-minimal or no risk of aspiration
-no foreseeable need for mechanical ventilation
-used for patient in the community who have tracheostomies

12

care considerations for tracheostomies

-always look at agency policy
-secure the trachea: 2 people to change ties
-PPE: mask, face shield, eye wear, gown
-stoma care:

13

stoma care

-stoma dry and clean
-dressing clean and dry (sterile)
-pre cut non raveling dressing (lint can cause aspiration/irritation)
(dry to prevent infection)

14

preparation for emergency situations (tracheostomy)

accidental documentation
equipment at bedside at all times:
-obturator
-suction equipment
-oxygen
-2 new tracheostomy's tubes (same size and one smaller)
Bag valve mask

15

what to do if the patient was accidentally decannulated

1. call for help: rapid response
2. can use sutures to hotd site open
3. lift head and tilt chin to get closer look at the stoma site
4. listen to stoma site for subcutaneous emphysema
5. use obturator and tracheostomy emergency either one size smaller, oxygenate the patient and monitor
6. use obturator and outer cannula. to guide back in
7. suction and provide oxygen `

16

Suctioning

PRN procedure: can increase secretions
-can be for any artificial airway

17

yankeuer: suctioning

used for oropharyngeal suctioning
-help remove copious secretions from the mother and back of the throat
-patient can use

18

portable suction apparatus

-most likely on code cart
-all rooms have wall suction

19

suctioning methods: open system

-single use
-infection risk: sterile procedure
-hypoxia can occur when thumb is on y port
stimulation of vagus nerve: coughing
PPE: gloves, googles, gown, mask

20

suctioning pre assessment

-baseline assessment: RR, Oxygen saturation, lung sounds
-signs of hypoxia
-effectiveness of cough
-HX of deviled septum, nasal polyps, epistaxis, nasal injury or swelling
-assess need for premedication

21

suctioning guidelines

-pre and post assessment
-put unconscious pt on side
-conscious pt in semi fowlers
-suction intermittently: cover the y port intermittently with non dominant hand, while rooting the catheter
-potential complications: hypoxia, infection, tracheal damage, dysrythymias, and atelectasis
-prevent hypoxia by hyper oxygenating pt before suctioning
-monitor pulse for effects of hypoxia and vagal nerve stimulation

22

suctioning procure considerations

-corret catheter size
-pre test suction
-hyper-oxygenate per facility
-3 passes, 10-15 sec each
-30sec-1min: between each pass
-set suction to 100-150 mmHG