Overview
This lecture covers the steps and key points for performing tracheostomy suctioning and tracheostomy care, emphasizing sterile technique and patient safety.
Preparation and Initial Steps
- Gather equipment: care kit, suction set-up, extra gloves, saline, peroxide, pen, stethoscope.
- Bring extra gloves in case of contamination.
- Ensure bed is at working height.
- Perform hand hygiene, introduce yourself, verify patient identity and allergies, and explain the procedure.
Suctioning Procedure
- Confirm oxygen is set up and suction pressure is 80-120 mmHg to avoid tissue damage.
- Prepare all needed items before donning sterile gloves.
- Listen to lung sounds, comparing both sides and all designated areas.
- Hyperoxygenate patient before suctioning; instruct on deep breathing.
- Maintain sterility: only touch cuffed areas of gloves and equipment.
- Insert suction catheter gently until the patient coughs, apply suction intermittently while twirling on withdrawal.
- Limit suctioning to three passes, allowing patient to recover between attempts.
- Reassess lung sounds after suctioning.
- Inspect nares and mouth for obstruction before proceeding if needed.
Tracheostomy Care Procedure
- Prepare supplies and ensure solutions are not expired.
- Set up sterile field and handle equipment without contaminating.
- Clean inner cannula using brush and saline/peroxide; rinse and dry thoroughly.
- Clean around stoma and under flange, rinse and dry to prevent skin breakdown.
- Replace trach tie: if one side is undone, keep one hand securing the trach at all times.
- Ensure new tie allows two fingers under for proper fit.
- Place gauze under trach for comfort and protection.
- Restore oxygen, place patient in a comfortable position, give call light.
Key Terms & Definitions
- Tracheostomy (trach) — surgical opening in the neck into the trachea to help breathing.
- Suctioning — removal of airway secretions using negative pressure.
- Sterile Technique — method to prevent contamination by pathogens.
- Flange — part of the trach tube that rests on the neck, securing it.
- Hyperoxygenation — giving extra oxygen before a procedure to prevent desaturation.
- Cannula — inner tube of a tracheostomy that can be removed for cleaning.
Action Items / Next Steps
- Practice both suctioning and trach care procedures using sterile technique.
- Prepare and check supplies before starting any procedure.
- Read assigned textbook section on tracheostomy care and suctioning.