Trach Class Flashcards
Tracheotomy?
A surgical incision in the trachea that forms a temporary or permanent opening called a tracheostomy
Normally done under general anaesthesia
Tracheostomy?
The opening made for the tube itself, the equipment and stoma
3 major indications for a tracheostomy tube?
Obstructed airway (upper)
-trauma, mechanical, tumour
Facilitate act of breathing
Remove secretions
Key factors to be considered in care if a trach patient?
Communication ability
O2 always humidified
Sunctioning
Mouth care
Mobilization/positioning
Why is O2 always humidified?
Keeps mucous membranes moist (cilia)
Still able to assist with removal of debris
Why do we suction for trach patient?
Keeps airway clean and maintain patency
Protect health of lungs
What safety equipment should always be present at bedside for trach pt?
Suction
Spare humidifier
2 spare trach insertion set -one the same size as current trach and the other one smaller
Oburator
Call bell
CPR mask/bag
Syringe if cuffed trach to increase or decrease balloon
What is obstruction of a trach tube usually caused by?
Secretions
What are some complications that might occur for patient with a trach?
Obstruction Abnormal bleeding Tube dislodgement Obstructed tube Subcu emphysema Tracheoesophageal fistula
What is a temporary trach used for?
Removal of secretions
Trach tube is inserted through the opening and bypasses normal airways to allow you to breathe and clear your secretions
Indications for trachs?
Maintain patent airway -by pass upper airway obstructions Facilitate the removal of secretions Decrease the work of breathing and increase volume entering the lungs Some cases of severe COPD Long-term ventilation
What level is incision for trach made?
Between 2&4 trachea cartilage
What would determine size of trach tube?
Anatomy of the client
Type of trauma
Site it’s going in at
Indications
Common sizes of trach tubes for gender?
Men: 8
Women: 6
Advantages to trachs?
Life saving Comfort Decrease risk of long term damage to airway Manageable at home Allows mobility and eating
Potential complications of trach?
Infection Risk of bleeding Aspiration Hypoxia Skin integrity Tube dislodgement Obstructed tube Subcu emphysema
Normal vs tracheostomy breathing?
Normal: breathe through nose and mouth so that air is filtered, warm and humidified before it goes down trachea to lungs
Tracheostomy: air goes directly into trachea to lungs
- air is not filtered, warm or humidified (increases mucous production)
- suction important
Outer cannula?
External tube that is inserted through the surgical opening
Provides artificial passage for breathing and may have a removable inner cannula
Inner cannula?
Goes inside pt
Keeps trach patent
Only found in 2 piece set
What is obturator?
Used to make tube more rigid on insertion
Plug
What is the flange?
Hard plastic piece located at the top of the tracheostomy tube that lies against your neck
Identifies the size and make of tube
What are fenestrated tracheostomies?
A specialized tube used for longer term trachs
Fenestrated refers to the holes in the outer, inner cannula or both that allows air to be directed past the vocal cords and through the mouth and nose
-allows speech
Speech and trachs?
Before fenestrated tube is used, swallowing ability is determined
Re-taught how to speak
Re-directs air over vocal cords
Always assess for resp distress
Cuffed tracheostomies?
The purpose of the cuff is to seal the airway so that all air flow goes though and not around the tube
-eliminates air flow through mouth and nose
Used in mechanical ventilation
