This document discusses tracheostomy care. A tracheostomy is an opening in the neck into the trachea that aids breathing. Tracheostomy care includes cleaning the site, changing inner tubes and dressings to prevent infection, maintain airway patency, and promote healing. It outlines the equipment, assessment, procedure, aftercare, responsibilities of nurses, and health education regarding tracheostomy care.

2. TRACHEOSTOMY CARE
BY:-
PREETI SHARMA
MSC. NSG. 1ST YEAR

3. INTRODUCTION
• A tracheostomy is an opening through the neck into the
trachea. A tracheostomy opens the airway and aidsbreathing.
• A tracheostomy may be done in an emergency, at the patient’s
bedside or in an operating room. Anaesthesia may be used
before the procedure. Depending on the person’s condition, the
tracheostomy may be temporary or permanent.

4. DEFINITION
Tracheostomy care includes changing a
tracheostomy inner tube, cleaning tracheostomy site
and changing dressing around the site

5. PURPOSE
1.To maintain airway patency
2.To prevent infection at the tracheostomy site
3.To facilitate healing and prevent skin excoriation around
tracheostomy care.
4.To promote comfort
5.To assess condition of ostomy

6. INDICATION
Acute Respiratory failure
Obstruction in the upper airway
Facilitate the removal of respiratory secretions
Subcutaneous emphysema
Neck trauma that results in severe injury to the thyroid or
cricoids cartilages

7. CONTRAINDICATIONS
Raised inter cranial pressure
Tracheo / Oesophageal fistula
Cancer in upper GI or respiratory tract
Oesophageal or high GI surgery

8. PARTS OF THE TRACHEOSTOMY

9. EQUIPMENT
I. Tracheostomy care kit containing
1.Gallipots-3
2.Sterile towel
3.Sterile nylon brush/ tube brush
4.Sterile gauze squares
5.Cotton twill ties or tracheostomy tie tapes

10. I. A clean tray containing
1.Hydrogen peroxide
2.Normal saline
3.Sterile gloves-1 pairs
4.Face mask and eye shield
5.Waterproof pad

13. PRELIMINARY ASSESSMENT
Check the physician’s order.
Explain the procedure to patient include instruction to co-operate.
Ensure patient’s privacy.
Provide the position which is comfort to patient. Usually semi-fowler
position is provided.
Monitor heart rate, respiratory rate, temperature, pulse, blood pressure,
arterial blood pressure and arterial blood gases.
Collect all the equipment and place in easy to take during the procedure.
Auscultate chest sounds.
Check the function of suction apparatus and resuscitation bag.
Wash the hands, dry the hands and wear gloves.

14. PROCEDURE

18. AFTER CARE
Remove your gloves and throw them away.
Provide comfort position to the patient.
Wash your hands with soap and warm water.
Wash the articles with soap and warm water.
Put the used wash cloth & towel in the laundry.
Discard all the waste materials.

19. NURSES RESPONSIBILITY
1. Tracheostomy dressing should be done every 8 hours or whenever dressing is
soiled
2. If disposable inner cannula is present, then replace the one that is inside with a
new one.
3. If only single lumen is present, clean the neck plate and tracheostomy site.
4. Emphasize the importance of handwashing before performing tracheostomy
care.
5. proper way on how to remove, change, and replace the inner cannula.
6. Check and clean the tracheostomy stoma.
7. Assess for symptoms of infection .

20. SCIENTIFIC PRINCIPLES
1. ANATOMY & PHYSIOLOGY
•The respiratory tract consists of nose, pharynx, larynx,
trachea, bronchi & lungs.
•The trachea is in front of the oesophagus so that the tube
can go into the trachea therefore the nurse must watch
placement of the tube.
•Skin is a soft flexible, membranous covering & is
continuous at the natural orifices with the mucus membrane.

21. CONT…
2. MICROBIOLOGY
•The nurse must wash her hands before & after procedure to
prevent cross infections.
•The intact skin is impassable barrier to microorganisms.
•All equipment used for the care should be clean. Seprate
articles may be kept for individual patient to prevent cross
infection.

22. CONT…
3. PHYSICS & CHEMISTRY
•Soap lowers the surface tension of water & helps it to unite
quickly.
•Oxygen passes from the air to the tissues, carbon dioxide passes
from the tissues to the air.
•Oxygen is used into the blood by means of respiratory system.

23. CONT…
4. PSYCHOLOGY
•Relieve the anxiety of the patient by explaining what the
procedure is, what she is going to do.
•Provide privacy by screening.
•Nurses should do her work as skillfully as possible so that her
power has been done to give the patient comfort & relief.

24. HEALTH EDUCATION
Cleaning the tube carefully at least once a day.
Wash your hands before and after care.
Place a pillow or rolled towel under your neck, it will help
open your airway.
Change wet or dirty ties.
Check your skin everyday for signs of infection like
redness, pus, bleeding etc.
Drink plenty of fluids.

25. CONCLUSION
In addition to suctioning the tracheostomy the nurse is
responsible for either cleaning anon-disposable inner cannula or
replacing a disposable one because soiled dressing of
tracheostomy places the patient at risk for the development of
skin breakdown & infection regularly change dressing & ties.