Tracheostomy is a surgical procedure in which an opening made in to the trachea. A tracheostomy may be either temporary or permanent. A tracheostomy is used to bypass an upper airway obstruction, to allow removal of tracheobronchial secretions, to permit the use of long term mechanical ventilation. Here are some important principles a nurse should follow while caring a patient with tracheostomy tubes.
- tracheotomy is usually made between 2nd – 3rd ( or 3rd – 4th) tracheal rings.
- tracheostomy cuff pressure should be minimum 15mmhg to prevent aspiration & maximum 25 to avoid the tracheal injury over inflation. cuff pressure should be checked every 8 hours
- Hyperoxygenate the patient for 30 seconds with hi-flow oxygen before doing suctioning to prevent hypoxia during procedure.
- Suctioning duration must be 5 to 10 seconds to prevent hypoxia which may result in dysrhythmias leading to cardiac arrest.
- do suctioning in 360 degree angle to clear secretions completely.
- Suctioning pressure should be 80mmhg minimum to 120mmhg maximum, to aid in removal of secretions without causing damage to tissues.