Week 7: Tracheostomy Care & Suctioning

Question 1

When is suctioning performed?

Answer 1

When airway needs to be cleared of secretions

Question 2

What kind of technique is recommended for suctioning?

Answer 2

Sterile technique

Question 3

What does suctioning prevent?

Answer 3

Infections in the lungs

Question 4

What is a collection chamber?

Answer 4

chamber that allows the measurement of the secretions in mm

Question 5

What is a suction control gage?

Answer 5

where you turn the suction on

Question 6

Oropharyngeal suctioning

Answer 6

Through the mouth
removes secretions from upper respiratory tract

Question 7

Nasopharyngeal suctioning

Answer 7

Through the nose
Removes secretions from upper respiratory tract

Question 8

Orotracheal Suctioning

Answer 8

going through the mouth but deeper into the trachea

Question 9

Nasotracheal suctioning

Answer 9

going through the nose then deeper into the trachea

Question 10

Tracheal suctioning

Answer 10

going through the trachea

Question 11

Endotracheal suctioning

Answer 11

going through endotracheal tube (artificial ventilation), removes secretions from bronchi as well

Question 12

How to indicate if suctioning is needed?

Answer 12

Respiratory distress
SOB
Coughing
Low O2 Sat
Cyanosis
Increased RR
Audible crackles

Question 13

What are complications of suctioning

Answer 13

Worsening respiratory status
Bloody secretions (trauma) (check pressure)
Coughing while suctioning
No secretions (secretions may be thick and need to be suctioned deeper)

Question 14

How long should you intermittent suctioning

Answer 14

No longer than 10 - 15 seconds

Question 15

What kind of suctioning prevents gag reflexes?

Answer 15

Nasotracheal suctioning

Question 16

Closed suctioning method

Answer 16

Allows for continuously delivery of oxygen while suctioning at the same time to reduce the risk for desaturating

Question 17

Open suction method

Answer 17

Using a sterile catheter that is opened at the time of suctioning and then discarded

Question 18

Hyperinflation (decreases complications)

Answer 18

Giving pt breaths that are 1 to 1.5 times total volume set on ventilator

Giving 3-5 breaths before and after each pass of suction

Question 19

Hyper oxygenation (decreases complications)

Answer 19

Increasing the oxygen flow usually to 100% before suctioning and in-between suctioning attempts

Question 20

How to document suctioning

Answer 20

amount, colour, odor, and consistency of secretions
breath sounds
respiratory and heart sounds before and after
patients response
frequency of suctioning
o2 rate

Question 21

Tracheotomy

Answer 21

Surgical incision in the trachea just before the larynx

Question 22

Tracheostomy

Answer 22

Opening made for tube itself (a stoma for tube)

Question 23

Tracheostomy Tube

Answer 23

Inserted to extend through the stoma into the trachea

Question 24

Outer Cannula

Answer 24

Inserted into the trachea

Question 25

Flange

Answer 25

Rests against the neck allowing the tube to be secured in place with taper ties

Question 26

What happens if we don’t secure the tube with a flange?

Answer 26

It’ll become dislodged, and if the stoma closed pt would not be able to breathe

Question 27

Obturator

Answer 27

Used to insert inner cannula and then removed

Question 28

Where is an obturator kept?

Answer 28

Patients bedside in case it becomes dislodged and needs to be reinserted

Question 29

Inner cannula

Answer 29

removed periodically for cleaning or changed
usually disposable

Question 30

Cuffed Tracheostomy Tubes

Answer 30

Creates an airtight seal preventing leakage of air
The inflated cuff creates the seal
Essential when ventilating a patient
As patient becomes more stable they will deflate the cuff

Question 31

What can’t a patient do with a cuffed tracheostomy tube?

Answer 31

Cannot swallow or chew

Question 32

What is involved in trach care?

Answer 32

Suctioning, removing dressing, cleaning stoma, changing inner cannula, and replacing trach ties

Question 33

What should you encourage a patient to do with a trach?

Answer 33

Cough to clear their airway
adequate hydration to thin secretions

Question 34

What is included in the patient preparation for trach care?

Answer 34

Patient in high fowlers or fowlers
Means of communication (blinking, raising a finger)