General Tracheostomy Information
|Types of Tubes|
- Assess Patient and Check Orders
- Assess the need for suctioning
- Assess the need for tracheostomy care
- What trach care is ordered? What to use? How often? Can you change the ties?
- Gather Equipment
Tracheostomy Care Kit
Suction Kit Sterile disposable inner cannula Tracheostomy ties and dressing as needed
Sterile normal saline, Hydrogen Peroxide, resuscitation bag, 10 ml syringe, and other supplies as needed
You can get additional information on tracheostomy care and supplies - See web sites below
- Insert Oral Airway
Remember that you need to invert the airway until you get past the tongue and then flip it over.
- Administer oxygen via resuscitation bag before and after suctioning
For tracheostomy ventilation, remove the mask and attach directly to the trach. Manually give breaths to preoxygenate the patient prior to tracheostomy suctioning.
- Do nasopharyngeal suctioning
- Do oral suctioning
- Deflate the cuff (must do after oral and nasopharyngeal suctioning
- Suction the tracheostomy
Review use of inline suction catheter
- Remove the inner cannula
This type of inner cannula twists to unlock or lock into place This inner cannula has clips on each side that hold it in place This cannula has an end with a tab similar to the ring on pop cans. You need to stabilize the trach while removing or inserting inner cannulas.
- Insert new or cleaned inner cannula maintaining sterility of cannula
- Clean around the stoma and trach tube flange using H2O2 and normal saline
- Replace dressing; do not slide over the skin
- Reinflate the cuff
- Change trach ties with help
For new tracheostomies, the physician orders when the ties can be changed in order to prevent accidental removal of the trach.
Never change ties alone with a new trach.
- Assess patient response
- Clean up and replace equipment
Here is a very good source of information as well as an interesting situation, a child with a tracheostomy.
American Head and Neck Society
Dale 240 Blue Tracheostomy Tube Holder
ICU - USA Tracheostomy