Wechsel der Trachealkanüle

Summary

This video provides detailed instructions on how to safely and effectively change a tracheostomy tube in a non-intubated patient. It covers the necessary materials, proper techniques, and safety measures, such as using sterile gloves, disinfecting the area, and preparing the required equipment. The procedure involves gently removing the old tube, cleaning the wound site, and carefully inserting a new tube, ensuring the patient’s airway remains open and unobstructed. The video emphasizes patient monitoring, proper sealing of the new tube, and post-procedure documentation.

Takeaways

• 😀 A Dragon tube change is a medical procedure that can be performed by qualified nursing staff.
• 😀 The procedure helps protect and stabilize the airways, especially after surgeries in the ear, nose, and throat area.
• 😀 Regularly changing the Dragon tube is important to avoid pressure sores and maintain clear airways.
• 😀 Preparation for the tube change involves sterile materials such as gloves, disinfectant, and a new tube.
• 😀 If the patient is heavily soiled, suction devices and multiple suction catheters should be ready for emergency use.
• 😀 It’s crucial to inform and communicate the procedure with the patient beforehand.
• 😀 The tube should be gently removed with a twisting motion, taking care to observe the wound for signs of infection or scabbing.
• 😀 After removing the old tube, the wound area and tube opening should be cleaned with sterile saline solution and swabs.
• 😀 A new Dragon tube is lubricated with a small amount of gel before insertion, and care should be taken to observe the patient's breathing during the procedure.
• 😀 If the tube is difficult to insert, try a smaller size, and use a spreader or suction catheter to assist with the insertion if necessary.

Q & A

What is the purpose of replacing a Dragon cannula?

The purpose of replacing a Dragon cannula is to ensure that the airways remain open, particularly after surgeries involving the throat, nose, or ears. This prevents pressure points and ensures free access to the airways.

Who is qualified to replace a Dragon cannula?

Although replacing a Dragon cannula is a medical procedure, it can be delegated to qualified nursing staff under the guidance of medical professionals.

What materials are required for replacing the Dragon cannula?

The materials needed include sterile gloves, hand disinfectant, mouth protection, a cleaning set with sterile swabs, a sterile underlay, saline solution, anesthesia gel, a new Dragon cannula, a fixation band, a Thoma compression, a Kilian retractor, and a flashlight. In case of excessive mucus, an aspiration device and catheters are also necessary.

What should be done if the patient is heavily congested?

If the patient is heavily congested, an aspiration device and multiple suction catheters should be used to clear the airways before proceeding with the cannula replacement.

How should the cannula replacement procedure begin?

The procedure begins by preparing the materials on a disinfected surface, followed by hand disinfection, and putting on sterile gloves and a mouth protection mask. The patient should be informed about the procedure, and if necessary, suction of secretions should be performed.

What should be done before removing the old Dragon cannula?

Before removing the old Dragon cannula, the fixation band should be loosened, and the cannula should be removed gently using a rotational movement while observing the surrounding area for signs of infection or irritation.

How is the new cannula prepared for insertion?

The new cannula is prepared by fixing the fixation band on one side, attaching the slit compression to the cannula, and applying a small amount of lubricant to ease insertion.

What should be monitored when inserting the new cannula?

During the insertion, it is important to observe the patient’s breathing and to insert the new cannula gently with a slight rotational movement. Suctioning may be necessary before or during the process.

What steps should be taken if the cannula does not fit easily?

If the cannula does not fit easily, attempt to use the next smaller size. If necessary, the Kilian retractor should be used to aid insertion, and a suction catheter can serve as a guide.

How is the new cannula secured after insertion?

The new cannula is secured by tightening the fixation band without pulling it too tight, allowing for one or two fingers of space between the band and the patient's skin. The slit compression should also be checked to ensure proper placement.