What is the most common problem with fenestrated tracheostomy tubes?
Fenestrated tracheostomy tubes may assist with phonation in patients who cannot tolerate a 1-way speaking valve; however, the risk of developing granulation tissue, tracheomalacia, and tracheal stenosis exists.
What is the purpose of inflating the cuff on a tracheostomy?
The purpose of the inflated tracheostomy tube cuff is to direct airflow through the tracheostomy tube.
When should a tracheostomy first change?
It is recommended that tracheostomy tubes without an inner lumen should be changed every 5-7 days. Patients with excessive secretions may require more frequent tube changes. The first tube change takes place 3-7 days post surgical tracheostomy.
What should be at the bedside of a patient with a tracheostomy?
All tracheostomy patients must have suction equipment and emergency supplies at the bedside. Emergency equipment is usually in a clear bag on an IV pole attached to the patient’s bed. A tracheostomy patient must be assessed every two hours to determine if suctioning is required.
When should trach cuff be inflated?
Inflate cuff 24 hours following initial tracheostomy tube placement (prevents accumulation of subcutaneous air and aspiration of secretions) Manual assisted ventilation/mechanical ventilation. Meals or nasogastric tube feedings for 30 minutes after if problems with aspiration are anticipated.
When should a tracheostomy suture be removed?
In patients who have a surgical or percutaneous tracheostomy created, sutures may be used to secure the flange of the tracheostomy tube to the skin. These sutures should be removed 5-10 days post insertion depending on local policy.
How do you reinsert a trach tube?
Put the obturator in the new tracheostomy tube and put a few drops of water on the end. Remove the old tracheostomy tube if it is around the neck. If it is partially in the stoma, you can try to gently reinsert the old tracheostomy tube.