Trach Care Flashcards
(28 cards)
Open System
Requires disconnection of the endotracheal or tracheostomy tube from the ventilator or oxygen therapy source and insertion of a suction catheter each time the patient requires suctioning
What should you assess the patient for prior to suctioning?
PAIN! administer pain medication as prescribed before suctioning
What position should you place a concious patient in when suctioning? What about if they are unconcious?
- Semi-fowlers position
If patient unconcious:
- place in appropraite position based on circumstance
For adults, suction pressure should be no more than _______ mmHg. Suctioning pressure can range between ______ - ______
150
80 - 120
Suctioning requires sterile technique. Know which hands control what part of the suctioning
Dominant vs nondominant hand
Dominant hand
- manipulate catheter
- MUST REMAIN STERILE
Non-dominant hand
- control suction valve (Y-port) on the catheter
- considered clean
Prior to suctioning you much hyperoxygenate the patient for _______ -_______ seconds
30 - 60 seconds
_______ gloved hand, pick up the sterile catheter.
Pick up the connecting tubing with your _________ hand and connect the tubing and suction catheter
Dominant
Non-dominant
Prior to inserting the suction into the trachea, you must flush the catheter after connecting it to the suction. How do you go about this?
Dip the tip of the catheter into the basin (of NS) and apply intermittent suctioning to flush and lubricate the tip for easier insertion
T/F: You should apply intermittent suctioning by occluding the y-port upon insertion of the catheter into the tracheostomy
FALSE, you do NOT want to occlude the y-port when inserting the catherter into the tracheostomy. Occluding the y-port means that suction is on. You do not want to suction when inserting the catherter because it might cause damage to airway mucosa and cause hypoxia.
You want to occlude the y-port when withdrawing the catheter in a circular motion.
How do you know how far to insert the catheter when suctioning?
insert until you feel resistance or until the client coughs
What motion should you withdraw the suctioning catheter from the tracheostomy tube?
withdraw in a circular motion using your index and thumb of ur dominant hand.
occlude the y-port intermittently using your non-dominant hand
Immediatley stop suctioning if the patients heart rate drops by ______ bpm
20
Do not suction for more than ______ - _______ seconds at a time
10 - 15
You have just suctioned the client have withdrew the catheter. What should you do immediatley after?
oxygenate the client again for at least 30 seconds
You have just oxygenated the client for 30 seconds after the first suctioning pass and plan to do another pass. What should you immedialtey do after?
rinse the catheter again by suctioning a few mL of the NS
How many suction passes are you allowed to do per episode?
3 passes
Suction the ________ after suctioning the trachea. Do not reinsert the tracheostomy tube after suctioning the _______.
oropharynx
mouth
Closed System
makes use of an in-line suction catheter device that remains attached to the ventilator or oxygen source circuit.
When using a closed system suction, how do you go about removing the suctioning catheter?
remove WITHOUT rotating. remove until you see a black mark, which indicates the end of the tube
When using a closed suctioning, attach the suction catheter to the patients ventilation port using your ____________ hand
nondominant
When using the closed suctioning, when you should insert the suction catheter?
once the catheter is attached to the patients ventilation, you must wait until inhalation to insert the suction catheter with the dominant hand
After assessing the client, it is time to perform trach care. What are the steps to this?
Include: cleaning inner content, outer content, replace ties
CLEANING INSIDE CONTENT:
1. Remove stoma dressing and place in waterproof bag
2. HH and new gloves
3. Grab disposable nasal cannula and make sure it is the correct size
4. Hyperoxygenate (or ask to take 5 deep breaths)
5. Prepare sterile field by placing sterile glove on DOMINANT hand (make sure hand stays sterile throughout the procedure)
6. Pour sterile solution into basin in sterile kit using nondominant hand
7. Place sterile glove on non dominant hand
8. Premoisten gauze and cotton tip that will be used for cleaning
9. Use nondominant hand to remove disposable inner cannula (if resuable, place in sterile solution to soak, clean lumen using pipecleaner, rinse, and dry)
10. Use dominant hand to insert new inner cannula (or cleaned cannula) with the curvature of tube in 1200 position
CLEANING OUTSIDE CONTENT
11. Clean outer cannula and trach site with sterile applicators that were premoistened
12. Rinse with premoistened guaze and pat dry with guaze pad
13. Apply new dressing with dominant hand
REPLACE TIES
14. Loosen the fasteners one side at a time and remove from neck (AS LONG AS YOU HAVE A SECOND PERSON TO HOLD THE TRACH IN PLACE)
-> IF NO, do not remove old holder until new one is secured
15. Apply new holder and fasten one side at a time
T/F: When performing trach cleaning, if the site is red, you should clean with hydrogen peroxide
FALSE, do not do this. Youll want to use NS
How many fingers should be able to fit under the ties when you are replacing them during trach care?
one finger
(some sources say 2 so idk)
