Tracheostomy Care: Replacing Trach Ties

Summary

This video demonstrates a two-person technique for safely replacing tracheostomy ties, highlighting the importance of regular assessment for patient safety. It outlines necessary supplies, including PPE and split gauze, and details the steps for replacing the ties while minimizing the risk of accidental decannulation. The process emphasizes the need for proper tightness to avoid complications and instructs on the correct placement of gauze. Designed for nurses and respiratory therapists, this guide aims to enhance patient care and prevent skin breakdown and infection.

Takeaways

• 😀 Tracheostomy ties, or trach ties, are Velcro devices used to secure tracheostomies at Trinity Health Livonia.
• 😀 These ties are disposable and should be regularly assessed for wear, moisture, or soilage.
• 😀 A two-person technique is recommended for safely replacing trach ties to prevent accidental dislodgment.
• 😀 It's important to gather necessary supplies, including PPE, new trach ties, and split gauze, before starting the procedure.
• 😀 Always use packaged split gauze instead of cutting whole gauze to avoid frayed edges that can lead to infection.
• 😀 When replacing ties, apply pressure to both sides of the flange to secure the tracheostomy in place.
• 😀 Proper tightness of the ties is crucial; it should allow for two fingers to fit between the tie and the patient's neck.
• 😀 After replacing the ties, ensure the split gauze is placed correctly under the flange to protect the stoma.
• 😀 Regular assessments of trach ties can help prevent complications such as skin breakdown and infections.
• 😀 Chart the intervention in Epic to maintain accurate patient records and ensure continuity of care.

Q & A

What are tracheostomy ties and their purpose?

Tracheostomy ties, or trach ties, are Velcro securement devices used to fasten tracheostomies, ensuring they remain securely in place on a patient's neck.

When should tracheostomy ties be replaced?

There is no standard timeline for changing trach ties, but they should be assessed regularly and replaced if they are wet or soiled to prevent skin breakdown and infection.

Who is responsible for replacing tracheostomy ties?

Both respiratory therapists and registered nurses can replace trach ties, but nurses are often the ones to identify the need for replacement based on regular assessments.

What supplies are needed for replacing tracheostomy ties?

Supplies needed include standard PPE (gloves, mask, eye protection), new trach ties, and packaged split gauze.

Why should whole gauze not be cut to create split gauze?

Cutting whole gauze to create split gauze can leave frayed edges, which may lead to infection. Always use packaged split gauze.

What technique is recommended for replacing trach ties?

A two-person technique is recommended, with one person applying pressure to both sides of the flange while the other replaces the ties.

What precautions should be taken during the tie replacement process?

Precautions include maintaining pressure on the flange to prevent accidental decannulation and ensuring the trach remains secure during the procedure.

How tight should the new trach ties be?

The new trach ties should be tightened to allow for two fingers to fit between the tie and the patient's neck, avoiding over-tightening to prevent pressure injuries.

How should the split gauze be applied?

The split gauze should be applied with the opening under the patient's chin, sliding it up from below the trach to ensure proper placement.

What should be done if there is concerning drainage from the trach site?

If the drainage appears excessive or abnormal in color, the respiratory therapist or physician should be contacted for further assessment.