Tracheostomy 101
UCLA uses this type of securement device for tracheostomies.
What is velcro?
Typically considered this type of procedure.
What is Sterile Procedure?
The frequency of when the stoma site should be cleaned.
What is q4-8 hours?
The person who performs the very first tube change on a patient.
Who is the MD/Surgeon?
Oftentimes, the first place you go to look for policy NUR-HS 129
What is the mednet home page?
This is how you check to ensure the trach ties are tight enough or too loose.
What is one finger under the ties?
This system allows for the child to remain connected to a ventilator while suctioning.
What is a closed tracheal suctioning system or inline suctioning?
The name of the Nurse you would contact if you notice breakdown at the stoma site.
Who is Geri (wound/ostomy nurse).
The three types of tracheostomy tubes used.
What is cuffed, uncuffed and fenestrated?
The length of time considered to be a fresh tracheostomy.
What is less than 48 hours old?
The type of dressing used for underneath the trach, trach ties, and for patients with copious secretions.
What is a thin foam dressing? The dressing wicks moisture and offloads pressure
The duration of time spent to decrease risk for trauma, hypoxemia, and other risks.
What is 10-15 seconds for suctioning?
The solution used to clean the inner cannula.
What is sterile normal saline or sterile water?
The frequency of when non-fresh tracheostomy tubes are changed here at UCLA.
What is weekly or q7days?
The care you give at least q4h on patients that have a tracheostomy.
What is Oral Care?
The reason for the use of humidification such as a trach collar in patients with a tracheostomy.
What is to prevent mucous plugs?
The pressure measurement level recommended for suctioning a pediatric patient.
What is 80-100mm Hg for infants and children and up to 120mm Hg for adolescents.
The frequency of when the inner cannula is inspected and cleaned.
What is two times daily?
The minimum number of staff present for a trach or trach tie change.
What is at least 2? One person to hold the tube in place and the other to change the securing device.
These patients are the only ones who should have an inflated tracheostomy cuff.
Who are mechanically ventilated patients?
Emergency equipment needed at bedside for every patient with a tracheostomy tube (Must name 4)
What are:
1.) Manual resuscitation bag with trach adapter
2.) Suction set up with extra suction catheters.
3.) Obturator
4.) Extra trach same size/type & one size smaller
5.) Inner cannula (same size) if applicable
6.) Trach cleaning kit
7.) Face Shield and PPE (needed for suctioning).
Evidence-Based Practice and per UCLA policy this intervention should NOT be done prior to suctioning.
What is instilling sodium chloride (pink bullets) into tracheostomy prior to suctioning?
Tracheostomy care including cannula cleaning and stoma care, given at the intervals specified by UCLA policy help to prevent these complications (must name 2 out of 3).
What is mucous buildup (or respiratory distress), maintain mucous membrane and skin integrity, and prevent infection.
Seeking the assistance of these people may be appropriate during these procedures.
Who are the Child Life Specialists?
If a tracheostomy cuff needs to be inflated only this person can perform this intervention.
Who is the Respiratory Therapist (RT)?