simple ppt

1. JOHNY WILBERT, M.Sc[N]
LECTURER,
APOLLO INSTITUTE OF HOSPITAL
MANAGEMENT AND ALLIED SCIENCE

2.  A tracheostomy is a surgical opening in the
anterior wall of the trachea just below the
larynx.
 It provides an alternative airway, bypassing
the upper passages.

3.  A tracheostomy tube
is:-
◦ Inserted through the
tracheostomy to
maintain a patent
airway
◦ Secured in place by
tapes tied around the
neck

4.  To provide and maintain a patent airway
 To enable the removal of tracheobronchial
secretions
 To permit long term positive pressure
ventilation
 To improve patient comfort
 To decrease the work of breathing and
increase volume of air entering the lungs

5.  Temporary
 Permanent
 Emergency
 Surgical
 Percutaneous
 Minitracheostomy
 Cricothyroidotomy

6.  Uncuffed

7.  Cuffed

8.  Fenestrated

9. ANATOMICAL POSITIONING OF
A TRACHEOSTOMY TUBE

10. PERCUTANEOUS TRACHEOSTOMY
INSERTION KIT (RHINO)

11. PERCUTANEOUS
TRACHEOSTOMY KIT

12.  SIZES RANGE
FROM 2.5MM TO 11
MM
 CURVED TUBE
 INFLATABLE CUFF
 FLANGES WITH
HOLES
 TUBE BLADDER

13.  HAEMORRHAGE
 SURGICAL
EMPHYSEMA
 PNEUMOTHORAX
 AIR EMBOLISM
 CRICOID
CARTILAGE
DAMAGE
 NERVE DAMAGE

14.  TRACHEAL STENOSIS,
ULCERATION, FIBROSIS,
TRACHEOMALACIA
 LOSS OF NORMAL
HUMIDIFYING AND
WARMING MECHANISMS
 LOSS OF PHYSIOLOGICAL
PEEP
 INCREASED RISK OF
NOSOCOMIAL PNEUMONIA

15.  Having a tracheostomy can be very traumatic
and many patients find it difficult to adjust.
 Patients with a new tracheostomy will need
lots of support, reassurance and education

16.  SAFETY FIRST
 RESPIRATORY CARE
 CARE OF THE STOMA
 COMMUNICATION/PSYCHOLOGICAL
 NUTRITION
 INFECTION CONTROL

17.  THERE ARE SPARE TRACHEOSTOMIES
AVAILABLE CLOSE BY 1 THE SAME SIZE
AND THE OTHER A SIZE SMALLER
 A TRACHEAL DILITATION KIT IS CLOSE
BY
 SUCTION EQUIPMENT IS AVAILABLE
 DIFFERENT SIZE SUCTION CATHETERS
AVAILABLE
 OXYGEN IS AVAILABLE
 EMERGENCY EQUIPMENT IS AVAILABLE
INCLUDING A RESUSCITATION BAG AND
MASK AND DEFIBRILLATOR AND
EMERGENCY DRUGS

18.  Provide high fowlers
position
 Administer humidified
oxygen
 Teach deep breathing
exercise
 Provide suctioning
when ever necessary
 continuously monitor
the spo2 level

19.  THE STOMA HAS TO BE
ASSESSED CAREFULLY
 IT NEEDS TO BE CLEANED
AND INSPECTED 2-3
TIMES A DAY
 IT SHOULD BE CLEANED
USING ASEPTIC
TECHNIQUE AND
APPROPRIATE DRESSINGS
APPLIED TO AID HEALING
 ONCE TUBE IS REMOVED
THE STOMA WILL CLOSE
SPONTANEOUSLY OVER
A FEW DAYS

20.  CHECK LOCAL POLICY ON EATING
AND DRINKING WITH
TRACHEOSTOMIES
 SOME TRUSTS ALLOW PATIENTS TO
EAT AND DRINK
 OTHERS DO NOT!!
 USUAL WAYS OF FEEDING INCLUDE
ORAL, NASOGASTRIC OR PARENTERAL.

21.  PATIENTS AND FAMILY
REQUIRE REASSURANCE
AND SUPPORT
 ALTERNATIVE METHODS OF
COMMUNICATION SHOULD
BE SOUGHT
 CONTACT S.A.L.T FOR
ADVICE ON
COMMUNICATION
 PROVIDE STIMULATION IN
THE FORM OF TELEVISION,
RADIO, NEWSPAPERS, ETC

22.  PATIENTS WITH TRACHEOSTOMIES
CAN BE FOUND IN MANY HEALTH
CARE ENVIRONMENTS FROM
INTENSIVE CARE/HIGH DEPENDENCY
TO THE COMMUNITY
 CARING FOR PATIENTS WITH
TRACHEOSTOMIES CAN BE DIFFICULT
BUT REWARDING