Cervical Traction
A patient in cervical traction may have a pillow under their head. True or False?
False, patients should be flat on the bed. Pillows may be used to support alignment.
What are three potential complications for patients in a halo?
pin site infection, restricted respiratory function, dural penetration, dysphagia
pneumothorax, hemothorax, pleural effusion, pleurodesis
How often should the inner cannula be changed?
Every 24 hours or PRN
What is the correct solution for cleansing a PEG site?
Soap and water. DO NOT use hydrogen peroxide as it is cytotoxic to human cells.
What is the proper technique for moving/repositioning a patient in cervical traction?
Turn the patient only if allowed by the provider. Log roll using a minimum of three caregivers. Maintain cervical alignment.
Name some assessment information that should be included with halos.
neurologic checks, swallowing, integumentary, pin sites
what should you do if the tubing becomes disconnected below the insertion site?
Cleaning of the trach site and changing the dressing should be completed how often?
every 8 hours and PRN
every 24 hours, using a toothbrush
When is cervical traction indicated?
Unstable cervical spine injury as a result of cervical spine fracture, dislocation caused by trauma or disease, degenerative processes of the cervical vertebrae, or spinal surgery
What should always be attached to the halo in case of emergency? How do you remove the plate to perform CPR?
wrench; lay on the patient on their back, use the black wrench to loosen the two bolts through the emergency washers on the front of the halo
what is tidaling?
if the patient is breathing spontaneously, the water level in the water-seal chamber should rise during inhalation and fall during expiration
Name some assessment findings that should be documented with trach care.
Color, amount, and type of secretions, appearance of stoma site, respiratory assessment (lung sounds), tolerance of suctioning, pain assessment
What are potential complications with a PEG tube?
skin infection, stoma erosion, buried bumper, aspiration
What are the most important guidelines to remember when caring for the patient in cervical traction?
Never raise the traction weights.
Never disconnect the traction.
Never allow the traction weights to rest on the floor.
Never allow other objects to compromise freely hanging weights.
What is most important to remember when moving a patient in a halo?
do not pull on the posts or struts
What do you do if a chest tube is accidently removed?
place a sterile dressing on the site and tape it on three sides. monitor the patient's vital signs, oxygenation, and respiratory status
Name 3 items that should always be at bedside when a patient has a tracheostomy.
Replacement trach/opterator, suction, oxygen set-up
What type of dressing should be used for the first four days after insertion of a PEG tube?
foam or hydrogel dressing (gauze can trap moisture)
What are the clinical symptoms of neurogenic shock that a cervical traction patient should be monitored for?
bradycardia, hypotension, respiratory distress
How often should pin site care be performed and what agents are used?
per provider order but generally done every 8 hours, hydrogen peroxide and antibiotic ointment for the first few days, then hydrogen peroxide only
What should you do if the trach is accidentally removed?
Assess patient’s airway status and oxygenation, if in distress/compromised then call for help/RRT and do not leave the patient, cover the stoma with sterile 4x4 gauze and gloved hand while a second person uses manual resuscitation bag and mask to ventilate patient
What do you do if a PEG tube is accidently removed?
Apply a dry sterile dressing to the site and immediately notify the surgeon to determine the urgency of replacement