Tracheostomy Care Lecture Notes

Overview of Tracheostomy Care

• Purpose: Demonstration of tracheostomy care.
• Structure: Two parts.
  • Part 1: Suctioning of the trach.
  • Part 2: Changing/washing the inner cannula and changing the dressing below the tracheostomy.

Preparations Before Tracheostomy Care

• Ensure all necessary equipment is in place:
  • Workstation on wheels.
  • Suction canister and machine.
  • Ambu bag attached to an oxygen source.
  • New tracheostomy tube with obturator at bedside for emergencies.
• Initial Steps:
  1. Check doctor's order.
  2. Sanitize hands.
  3. Introduce self to the patient and verify patient identity (name, date of birth, arm band check).
  4. Explain procedure to the patient.

Equipment Check

• Ambu Bag:
  • Ensure it is attached to oxygen and operational.
• Suction Machine and Canister:
  • Settings: 80-100 mmHg for suctioning.
• Positioning the Patient:
  • Raise patient's bed and head to a 45-degree angle.
  • Listen to breath sounds before suctioning (review physical assessment video if needed).

Supplies for Suctioning a Tracheostomy

• Sterile normal saline or sterile water.
• Sterile container.
• Sterile suction catheter.
• Two pairs of sterile gloves.

Sterile Technique and Suctioning Procedure

• Preparation of Supplies:
  • Check sterile water/saline bottle for expiration.
  • Label the bottle if first opened (date, time, initials).
  • Pour saline into sterile container ensuring sterility.
• Gloving and Suction Catheter Setup:
  • Put on sterile gloves; start with the dominant hand.
  • Wrap suction catheter around the dominant hand.
  • Deliberately contaminate the non-dominant hand to handle the suction tubing.
  • Attach catheter to suction tubing.
  • Check suction functionality.
• Hyperoxygenation Before Suctioning:
  • Encourage patient to take deep breaths.
  • Use ambu bag if needed.

Suctioning Process

• Insertion:
  • Insert catheter without suction until resistance is felt.
• Withdrawing:
  • Activate suction only when withdrawing.
  • Twist catheter to clean all surfaces.
  • Patient may cough during the process.
• Post-Suctioning:
  • Check suction tubing.
  • Reassess patient’s breath sounds.
  • Consider if additional suctioning is needed.

Concluding Suctioning

• Replace mist collar over trach.
• Turn off suction machine.
• Dispose of catheter and remove gloves.
• Ensure trach tent is secured.

Next Steps

• Part two will cover cleaning the inner cannula and the dressing site.

These notes summarize the key points for tracheostomy care presented in the lecture, focusing on preparation, equipment checks, sterile techniques, and the suctioning process.