Clinical Nursing Procedures: The Art of Nursing Practice

11.15: PROVIDING TRACHEOSTOMY CARE

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

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

EQUIPMENT__________________________________________________________________________________________________
' 1. Tracheostomy care kit containing
a. Gallipots (3)
b. Sterile towel
c. Sterile nylon brush/Tube brush
d. Sterile gauze squares
e. Cotton twill ties or tracheostomy tie tapes
f. Sterile bowl for solution 2- A
clean tray containing:
a. Sterile suction catheter
b. Hydrogen peroxide
c. Normal saline
d. Sterile gloves-2 pairs
e. Clean scissors
f. Face mask and eye shield (optional)
g. K Basin
h. Waterproof pad 3.
Suction apparatus
PROCEDURE
PROCEDURE
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Nursing action Rationale
1. Assess condition of stoma: (Redness, swelling, character of Presence of any of these indicates infection and culture test
secretions, presence of purulence or bleeding. may be warranted.
Indicates air leak into subcutaneous tissue.
Examine neck for subcutaneous emphysema evidenced by crepitus
2.
around the ostomy site.
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3. Obtains cooperation from patient.

Explain procedure to the patient and teach means of communication

such as eye blinking or raising a finger to indicate pain or distress.
4.
Assist patient to a Fowler's position and place waterproof pad on
chest. Promotes lung expansion. Prevents soiling of linen.
5. Wash hands thoroughly. Prevents cross-infection.
6.
Assemble equipments,
a. Open the sterile tracheostomy kit, pour hydrogen peroxide and Hydrogen peroxide and saline removes mucus and (S crust
sterile normal saline in separate gallipots. which promote bacterial growth.
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