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12 Cards in this Set
- Front
- Back
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Name indications for a tracheostomy |
Policies and Procedures Airway obstruction associated with, but not restricted to: trauma to the trachea, presenceof a tumour, laryngeal edema, anaphylactic reaction with no possibility to intubate,tracheal stenosis, vocal cord paralysis, neuro-degenerative diseasesProlonged intubation with difficulty to wean from ventilator Prophylactic airway management to some head and neck surgeriesAirway compromising conditions such as cerebrovascular accident, severe epistaxsis |
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How often should the suction tubing and liner be changed? |
q 3 days |
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Should a dietician be contacted for pts with trachs? |
Yes, a consult should be made automatically to the dietitian whenever a patient is scheduled for atracheostomy or is admitted with a previously inserted tracheostomy. |
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What are s/s of resp distress? |
Increased resp rate, diaphoresis, use of accessory muscles, cyanosis around lips or finger nails, grunting, nose flaring, retractions, wheezing, restlessness, anxiety, |
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What equipment is needed for suctioning? |
Sterile suction catheter kit 14 Fr250 mol bottle of normal salineSuction set-up (suction canister, disposable liner, regulator)Connecting tubingPersonal Protective Equipment (PPE) (non-sterile gloves, mask, face shield) |
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What is the pressure that should be exerted while suctioning? |
80 - 120 mmhg |
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What should you document about trach care? |
condition of tracheal incision and peristomal skindescription of secretions (color, consistency)respiratory statuspatient teaching performed patient’s reaction to the procedure |
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What position should the pt be in when changing the trach ties? How tight should the ties be? |
semi-fowler's. You should be able to place 2 fingers between the patient's neck and the ties. |
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What do you do if there is bleeding or hematomaformation at insertion site? |
Notify physician immediately. Monitor for resp distress. |
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What do you do if a patient with a trach is desaturating or dyspneic? |
1. Verify if mucous plug ispresent in inner cannula. Change as needed 2. Perform suctioning 3. Reposition patient 4. Administer oxygen asneeded 5. Assess breath sounds and monitor respiratory rateand oxygen saturation 6. notify physician |
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What do you do if the patient has increased amount of secretions or a change in the consistency/colour of secretions? |
Plan for more frequentinner cannula changes. Notify Physician. Assist Physician withchange of outer cannula. Perform suctioning. Monitor temperature. Send sputum for cultureand sensitivity |
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After dissimulation, what do you do if your patient is experiencing voice hoarseness, aphonia,difficulty breathing, use ofaccessory muscles? |
Notify the physician immediately. Could be: Tracheomalacia defined assoftening of tracheal wall,leading to tracheal collapse |
