1. Tracheostomy is a surgical opening in the front of the trachea below the larynx that creates an airway. It is performed to maintain a clear airway, remove secretions, and enable ventilation. 2. Tracheostomy tubes can be plastic, metal, cuffed, or fenestrated. Speaking valves allow vocalization without finger occlusion using a silicone diaphragm that opens for inhalation and closes for exhalation. 3. Complications include bleeding, infection, tube obstruction, aspiration, and tracheal stenosis. Care involves cleaning the stoma and tube, suctioning secretions, providing humidification, and assessing for ineffective airway clearance or

1. University of Babylon
Faculty Of Nursing
Tracheostomy Care
PREPARED BY:
Master Student
Haider mohammed

2. ANATOMY

3. Tracheostomy
It is a surgical opening in the anterior wall of the
trachea just below the larynx. Or is an operative
procedure that creates a surgical airway in the
cervical trachea.A tracheostomy may be performed
as a permanent and emergency procedure.

4. INDICATIONS:-
1-To provide and maintain patent airway.
2-To enable the removal of tracheo-bronchial
secretions.
3-To permit long term positive pressur ventilation.
4-To improve patient comfort.
5-To decrease the work of breathing and increase
volume of air entering the lungs

5. TYPES OF TRACHEOSTOMY
TUBES
Plastic or metal
Cuffed
Fenestrated

6. TYPES OF TRACHEOSTOMY
TUBE
PLASTIC
METAL

7. TYPES OF TRACHEOSTOMY
TUBES
CUFFED
FENESTRATED

8. Tracheostomy Speaking Valve
Tracheostomy Speaking Valve is designed to allow
tracheostomy patients to vocalize without the need for
finger occlusion. The valve provides low resistant one-
way airflow using a thin silicone diaphragm that opens
on inspiration and closes on expiration. An exclusive
feature of this valve is a "cough-release" mechanism,
eliminating valve or tube dislodgment as a result of
coughing or excessive airway pressure.

9. Indications For use as a one-way speaking valve
on a tracheostomy tube
Features
1-Easy to use and maintain
2-Low resistance to inspired airflow
3-Exclusive cough-release feature

10. speaking valve

11. Contraindications.
1-Suspected CSF leak (BOS fracture) or raised inter
cranial pressure.
2-Tracheo/oesophageal fistula.
3-Cancer in upper GI or respiratory tract.
4-Oesophageal or high GI surgery.

12. ANATOMICAL POSITIONING OF
TRACHEOSTOMY TUBE

13. COMPLICATIONS
Immediate
1-Hemorrhage
2-Hypoxia
3-Trauma to recurrent laryngeal nerve
4-Damage to esophagus
5-Pneumothorax
6-Infection
7-Subcutaneous emphysema

14. COMPLICATIONS
Early
1-Tube obstruction or displacement
2-Pooling of secretions leading to aspiration
3-Bleeding from tracheostomy site
4-Infection

15. COMPLICATIONS
Late
1-Airway obstruction with aspiration
2-Damage to larynx (Stenosis(
3-Tracheal stenosis
4-Tracheomalacia
5-Aspiration and pneumonia
6-Fistula formation .eg. Tracheo- cutaneous or
tracheo-oesopheal

16. CARE OF THE PATIENT WITH
TRACHEOSTOMY
Stoma care
1-care towards hygiene and asepsis is necessary.
2-Remember the skin surrounding the stoma is
also prone to irritation.
3-as per hospital policy and barrier cream
applied to the local skin cotton wool should
be avoided.

17. CARE OF THE PATIENT WITH
TRACHEOSTOMY
Tube care
1-Tubes need to be cleaned.
2-The area should be cleaned with normal saline {In
double cannula the inner cannula will need to be
removed and to be cleaned.
3-For cuffed tracheostomy tubes the pressure should
be measured in every shift{ as per hospital policy.{

18. CARE OF THE PATIENT WITH
TRACHEOSTOMY
Suctioning
1-Suctioning should be done PRN ,after chest PT and
Nebulization
2-Use the lowest pressure needed ,usually less than
120 mmHg and definitely not beyond 200mmHg.
3-Suctioning should be performed less than
10seconds.

19. Hazards Of Suctioning
1-Patient anxiety.
2-Changes in ICP.
3-Trauma.
4-Infection.
5-Pneumothorax.
6-Hypoxia.
7-Cardiac hazard.

20. CARE OF THE PATIENT WITH
TRACHEOSTOMY
Humidification
1-The normal humidification and air filtration system
is bypassed if the tracheostomy is in situate
2-Keep patients well hydrated- otherwise secretion
will become thicker and will lead to infection.

21. Nursing Diagnosis
1-Risk of ineffective air way clearance
related to increase secretion secondary to
tracheostomy.
2-Risk for infection related to excessive
polling of secretion.
3-Impaired verbal communication related
to inability to produce speech secondary to
tracheostomy.

22. Nursing Management
1-The patient and all hospital staff will
demonstrate and apply hand washing technique
through hospitalization.
2-the nurse educate the patient and his family
about transmission of infection after discharge.
3-assess and maintain for adequate humidity of
inspired air every two hours.
4-keep stoma free from any debris or mucous
build up as needed
5-check body vital sings.
6-keep patient with comfortable position.
7-give analgesic medication as order.

23. THINGS TO REMEMBER
DON’T PANIC
STERILE TECHNIQUE
SAFTEY FIRST
CRITICAL THINKING
NUTRITION
COMMUNICATION