Tracheostomy Care Lecture Notes (Part Two)

Supplies Needed

• New set of trach ties or trach collar
• Sterile normal saline
• Hydrogen peroxide
• Sterile tracheostomy kit
• Two pairs of sterile gloves

Preparation Steps

• Open working table for larger surface
• Identify patient, wash hands, inform patient of procedure
• Loosen mist collar for ease of removal
• Loosen caps of sterile normal saline and hydrogen peroxide
• Open tracheostomy kit
  • Remember: 1-inch border around sterile field is non-sterile
• Arrange supplies on sterile field
  • Pour solutions (hydrogen peroxide, sterile normal saline)
  • Be cautious to avoid splashing

Sterile Field Arrangement

• Place sterile drape on patient’s chest (shiny side down)
• Arrange supplies without leaning over the field
  • Pipe cleaners (for drying tracheostomy)
  • Sterile tweezers (for dressing placement)
  • Brush (for cleaning inside tracheostomy tube)
  • Twill tape (for securing tracheostomy)
  • Sterile 4x4s (for drying tracheostomy)
  • New drain sponge
  • Q-tips (for cleaning around trach)
  • Three containers (for solutions)

Cleaning Procedure

1. Remove Inner Cannula

   • Twist and remove inner cannula
   • Place in hydrogen peroxide
   • Remove old dressing and check for drainage
   • Discard old dressing
   • Re-sanitize hands

2. Cleaning the Cannula

   • Brush to clean inside and outside of tracheostomy tube
   • Rinse with sterile normal saline
   • Dry using sterile 4x4s and pipe cleaners
   • Inspect for damage or lint
   • Reinsert inner cannula and lock in place
     • Ensure blue dots align and hear/feel a click

3. Cleaning Around the Tracheostomy

   • Use three Q-tips moistened with sterile normal saline
   • Clean around tracheostomy and face plate
   • Dispose of used Q-tips
   • If necessary, add extra Q-tips at the beginning

4. Replacing Dressing and Ties

   • Use forceps to place drain sponge under face plate
   • Change trach ties (ensure trach is secured at all times)
     • New trach collar should fit 1-2 fingers between collar and skin

Post-Procedure

• Dispose of gloves and used supplies
• Ensure patient comfort
  • Rail up, call light within reach, comfortable position

Conclusion

• End of tracheostomy care and sectioning video
• Thank you and see you next time