A tracheostomy is a surgical procedure in which an opening, called a stoma, is created in the neck in order to provide an alternate airway. There are different types of tracheostomy and they are categorized based on the method of their creation, the type of tube used, and the intended duration of use.
- Cuffed Tracheostomy Tube: It is the most commonly used type of tracheostomy tube. The tube has an inflatable cuff that helps to seal the tube to the trachea and prevents air leakage.
- Uncuffed Tracheostomy Tube: It is used for patients who do not require a high level of airway protection. The tube does not have an inflatable cuff, which allows for easier speaking and coughing.
- Disposable Tracheostomy Tube: It is a single-use tube that is intended for short-term use, typically less than 14 days. It is more convenient but more expensive than the traditional tube.
- Reusable Tracheostomy Tube: It is a tube that can be used multiple times and typically has a longer duration of use.
Tracheostomy care is important to ensure the patient’s safety and comfort and to prevent complications such as infection or blockage of the airway. Here are some steps that can be taken to care for a tracheostomy:
- Keep the area around the stoma clean and dry: The nurse should regularly clean the skin around the stoma with a mild soap and water, and then dry the area thoroughly.
- Change the tube and inner cannula as needed: The nurse should change the tube and inner cannula as directed by the physician, typically every 2-4 weeks or sooner if the tube becomes blocked.
- Monitor the tube for proper positioning: The nurse should monitor the tube to ensure it is properly positioned in the trachea and not blocked.
- Maintain the cuff pressure: The nurse should check and maintain the cuff pressure as directed by the physician, usually between 20-30 cm H2O
- Administer medication: The nurse should administer medication as directed by the physician, such as bronchodilators and antibiotics, through the tube.
- Monitor the patient’s vital signs: The nurse should regularly check the patient’s vital signs, such as blood pressure, heart rate, and oxygen levels, to ensure they are within normal ranges.
- Keep accurate records: The nurse should keep accurate records of the patient’s care, including vital signs, medication administration, and any complications or changes in the patient’s condition.
It’s important for the nurse to have the necessary training and knowledge to care for the tracheostomy patient and also it is important to have regular follow up from the physician and respiratory therapist to ensure the patient’s safety and well-being.
Nursing ability to take care of tracheostomy
Tracheostomy care requires specialized knowledge and skills, and nurses play a critical role in providing safe and effective care for patients with tracheostomies. Here are some abilities that a nurse should have to take care of tracheostomy patients:
- Knowledge of anatomy and physiology: Nurses should have a thorough understanding of the anatomy of the airway and the physiological changes that occur with a tracheostomy.
- Technical skills: Nurses should be skilled in performing tracheostomy tube changes, suctioning, and maintaining the tracheostomy tube and cuff pressure.
- Monitoring skills: Nurses should be able to monitor the patient’s vital signs, oxygenation and ventilation status, and assess the patient’s overall condition.
- Communication skills: Nurses should be able to communicate effectively with the patient and their family, as well as other healthcare professionals, to ensure the patient receives appropriate care.
- Problem-solving skills: Nurses should be able to identify and solve problems that may arise with the tracheostomy tube or ventilator, and know how to respond to emergencies.
- Education skills: Nurses should be able to educate the patient and their family about tracheostomy care and how to manage the patient at home.
- Critical thinking: Nurses should be able to evaluate the patient’s condition and make decisions about the patient’s care.
- Empathy: Nurses should be able to show compassion and understanding towards the patient and their family, and be able to provide emotional support.
It’s important for the nurse to have the necessary training and knowledge to care for the tracheostomy patient, and also it is important to have regular follow up from the physician and respiratory therapist to ensure the patient’s safety and well-being. Nurses should also stay current with the latest research, guidelines and best practices to provide the best care to the patient.