🫁 TRACHEOSTOMY CARE PROCEDURE

1. Definition

• Tracheostomy care is a sterile procedure of cleaning and maintaining the tracheostomy tube and stoma to ensure airway patency and prevent infection.

• A tracheostomy is a surgical opening made in the trachea to facilitate breathing.

2. Purpose

• To maintain airway patency

• To remove secretions

• To prevent infection

• To ensure proper functioning of tracheostomy tube

3. Indications

• Airway obstruction

• Prolonged mechanical ventilation

• Respiratory failure

• Head and neck surgeries

4. Contraindications

⚠️ No absolute contraindication for care, but:

• Use caution in fresh tracheostomy (first 24–48 hrs)

• Avoid excessive manipulation

5. Articles / Equipment

🧰 Equipment:

• Sterile tracheostomy care set

• Sterile forceps

• Suction apparatus

🧴 Supplies:

• Sterile gloves

• Normal saline

• Hydrogen peroxide (if prescribed)

• Sterile gauze

• Tracheostomy ties

📋 Records:

• Patient chart

6. Patient Preparation

• Explain procedure to patient

• Position patient in semi-Fowler’s position

• Provide privacy

• Ensure adequate lighting

7. Procedure Steps (Step-by-Step Sentences)

1. Wash hands thoroughly and prepare all required articles.

2. Explain the procedure to the patient and ensure comfort.

3. Position the patient in semi-Fowler’s position.

4. Place a towel or mackintosh under the neck area.

5. Perform suctioning if secretions are present.

6. Open sterile tray and wear sterile gloves.

7. Remove the old dressing carefully using forceps.

8. Inspect the stoma for redness, swelling, or discharge.

9. Remove the inner cannula (if present) carefully.

10. Clean the inner cannula with normal saline or prescribed solution.

11. Dry the cannula and reinsert it properly.

12. Clean the stoma area using sterile swabs from center outward.

13. Use each swab only once and discard properly.

14. Apply sterile dressing around the stoma.

15. Change tracheostomy ties if required, ensuring tube stability.

16. Ensure the tube is secure and patient is comfortable.

17. Dispose of waste properly as per biomedical guidelines.

18. Remove gloves and wash hands.

19. Document the procedure and observations.

8. Post Procedure Care

• Check airway patency

• Monitor breathing pattern

• Ensure patient comfort

• Provide humidified air if needed

9. Complications

• Infection

• Tube blockage

• Accidental dislodgement

• Bleeding

10. Health Education

• Maintain cleanliness of stoma

• Avoid water entry into tube

• Recognize signs of infection

• Seek immediate help if breathing difficulty occurs

🎯 Viva Questions

Q1. What is tracheostomy?👉 Surgical opening in trachea for breathing

Q2. Why is suctioning done?👉 To remove secretions and maintain airway

Q3. What is the main complication?👉 Airway obstruction