Tracheostomy Care and Suctioning - Clinical Nursing Skills |@LevelUpRN​

Summary

In this detailed video, Ellis from LevelUp RN demonstrates essential tracheostomy care techniques, including tracheal suctioning, site care, and working with reusable inner cannulas. The step-by-step guide highlights best practices for cleaning, maintaining sterility, and managing trach ties to ensure patient safety and comfort. The video also emphasizes the importance of correct procedures for suctioning, such as ensuring the right suction pressure and giving patients oxygen breaks. Key tips include maintaining sterility, checking equipment before use, and securely replacing trach ties to prevent complications. This tutorial is a comprehensive resource for nursing professionals learning tracheostomy care.

Takeaways

• 😀 Proper tracheostomy care varies based on the type of equipment (reusable vs. nonreusable inner cannula).
• 😀 Always maintain sterility when handling the trach site and equipment to prevent infections.
• 😀 When cleaning the trach area, always start at the stoma and clean outward to avoid introducing bacteria into the respiratory tract.
• 😀 Reusable inner cannulas should be cleaned thoroughly with saline, a brush, and pipe cleaners before reinsertion.
• 😀 Only use precut gauze for tracheostomy site care, never cut a four X four gauze, to avoid the risk of fraying and inhalation.
• 😀 When changing the trach tie, ensure that the new tie is secure before removing the old one to prevent accidental dislodgement of the trach.
• 😀 Always check the suction device and confirm its functionality before starting the suctioning procedure.
• 😀 Hyper-oxygenate the patient before suctioning to ensure they have enough oxygen during the process.
• 😀 Use your non-dominant hand for controlling the suction and your dominant hand for guiding the catheter into the trach site.
• 😀 Perform suctioning in 15-second intervals and allow the patient to rest and re-oxygenate between passes to minimize stress and oxygen deprivation.
• 😀 When replacing oxygen and securing the patient, always ensure that the trach is in place and the tie is neither too tight nor too loose—allow one finger to fit comfortably underneath the tie.

Q & A

What are the key steps involved in performing tracheostomy care as demonstrated in the video?

The key steps include removing the inner cannula (if reusable), cleaning the trach site, replacing the trach tie, and ensuring sterility throughout the procedure. The video also covers suctioning the trach site using sterile technique and ensuring the patient is comfortable and properly oxygenated.

What is the difference between a reusable and a non-reusable inner cannula?

A reusable inner cannula can be cleaned and reinserted, while a non-reusable inner cannula must be discarded and replaced with a new one after use.

Why is it important to maintain sterility during tracheostomy care?

Maintaining sterility is crucial to prevent infection, as the tracheostomy is a direct pathway to the respiratory tract, which must remain sterile to avoid introducing harmful bacteria.

What should you do if the suction catheter touches non-sterile surfaces during the procedure?

If the suction catheter touches non-sterile surfaces, you should discard it and use a new sterile catheter to maintain infection control and avoid introducing pathogens into the respiratory tract.

How should the trach tie be secured to ensure patient safety?

The trach tie should be secured tightly enough to keep the tracheostomy tube in place, but not so tight that it restricts airflow or causes discomfort. One should be able to slip a finger under the tie to ensure it's not too tight.

What should be done before suctioning a patient's tracheostomy site?

Before suctioning, the patient should be placed in a semi or high Fowler's position and hyper-oxygenated to ensure they receive adequate oxygen during the suctioning process.

What is the proper technique for suctioning a tracheostomy site?

To suction, the catheter should be inserted into the tracheostomy until resistance is felt or the patient coughs. Suction should only be applied intermittently during withdrawal of the catheter, and each pass should last no longer than 15 seconds.

What is the maximum number of suction passes that should be made during a single suctioning session?

A maximum of three suction passes should be made during a single session. After each pass, the patient should be allowed to rest and re-oxygenate.

What equipment is required for tracheostomy suctioning, according to the video?

The equipment required includes a suction canister, tubing for the canister, a suction catheter, normal saline, and sterile gloves. It is also important to ensure that the suction is functioning properly before starting the procedure.

Why should you avoid using non-sterile materials, like cut gauze, during tracheostomy care?

Non-sterile materials, such as cut gauze, can fray and introduce foreign particles into the tracheostomy site, potentially causing an obstruction in the respiratory tract or infection.