NUR 340L Lecture Notes - Lecture 6: Tracheotomy, Airway Management, Croup

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8 Feb 2017
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Tracheostomies
- Tracheostomy tube
Long term airway management
Often used for patients requiring prolonged mechanical ventilation
Patients may be candidates for speaking valves
Complete healing of the stoma typically takes approximately 1 week
Dislodgement during the first postoperative week is a medical emergency
The most common cause of obstruction is a buildup of respiratory secretions in the tube
Suction via the tube can immediately remedy this
Most tracheostomies have an inner tube; small plastic inner tube sits inside a larger one
Humidification; prevents drying of secretions and occlusion
Reduced ability to heat, moisten and filter, and to cough
The purpose of the cuff is to provide a closed system
Under inflation of the cuff promotes leakage
Over inflation of the cuff can cause tracheal ulcerations
- Trach care
Site should be inspected for indications of inflammation and infection
Dressing changes as per policy or as needed
Suctioning as needed
Assess communication needs
Trach may be fenestrated or cuff deflated for air to pass through vocal chords for
speaking speech therapy
- Suctioning
Oropharyngeal
Suction set-up
Yankeur catheter
Nasopharyngeal
Smaller flexible sterile catheter, use sterile technique
Duration of procedure (10-15 seconds)
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