Tracheostomy care Instructed patient caregiver It is important to routinely clean the skin around the opening of the tracheostomy (stoma). This will help prevent skin irritation and the build-up of secretions.
Instructed patient sterile technique includes: Hand washing, Wearing sterile gloves. Using a new trach tube, inner cannula, and trach tie. Using sterile water (new bottle or bag every 24 hours). Discarding suction catheters after each use.
Instructed patient Clean technique includes: Hand washing, Using gloves is optional. Re-using a trach tube and/or inner cannula that has been properly cleaned, Using prepared sterile water and normal saline. Re-using the same trach ties if they are properly cleaned. Re-using suction catheters if they are properly cleaned(up to 8 hrs or 3/per day)
Instructed patient as much as possible, the skin should be kept clean and dry. You may need to clean the skin around the trach tube several times throughout the day. Call your doctor if you notice thick secretions that are yellow or green in color.
Instructed patient on signs and symptoms that indicate a need for suctioning include: Seeing mucus in the opening of the trach tube or hearing mucus in the airway Increased respiratory rate or effort Retractions (which is seen when the skin between the ribs pulls in while breathing.
Instructed patient on signs and symptoms that indicate a need for suctioning include: Nasal flaring (which is seen when the nostril flares out when a person breaths in) Change in skin color from normal to pale or blue Changes in activity, such as if a child is upset or inconsolable, or appears to be sleepy Increased coughing.
Instructed patient be careful not to touch the trach cannula while changing the tube. You do not want to contaminate the cannula. Other times to suction include before eating, or before and after sleeping. Be aware that every sound you hear does not mean they need to be suctioned.
Instructed patient supplies that can be cleaned and disinfected for re-use: Trach tubes Trach swivel adapters Trach ties, Aerosol masks ,T-Pieces, Speaking valves, Nebulizers, Most hard plastic supplies. Cleaning your respiratory equipment: (Weekly),Cleaning and Disinfecting the Humidifier: (Daily)
Instructed patient in emergency care These pages will cover prevention of an emergency situation, and what to do if: Your loved one has trouble breathing or stops breathing You cannot insert a trach tube The trach falls out.
Instructed patient the following is a list of preventive measures that may help to avoid some problems: Make sure the trach is getting enough humidity. Humidity will keep the mucus loose and decrease the chances of a mucus plug. If you hear a whistling sound from the trach, this might mean that the airway is dry. Always make sure the trach ties are securely fastened and are tight enough around the neck.
