1 / 15

Upper Airways - Terms

Upper Airways - Terms. Endotracheal Intubation (ETT) Oral-tracheal Naso-tracheal Tracheostomy (trach). Indications for Tracheostomy. Ineffective Airway Clearance r/t upper airway obstruction Inability to remove secretions congenital abnormality Severe neck or mouth injuries

lovey
Download Presentation

Upper Airways - Terms

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Upper Airways - Terms • Endotracheal Intubation (ETT) • Oral-tracheal • Naso-tracheal • Tracheostomy (trach)

  2. Indications for Tracheostomy Ineffective Airway Clearance r/t • upper airway obstruction • Inability to remove secretions • congenital abnormality • Severe neck or mouth injuries Ineffective Breathing Pattern • Long-term mechanical ventilation

  3. Desired outcomes of suctioning • Maintain a patent airway • Demonstrate a reduced work of breathing • Stimulate cough reflex • Prevent aspiration of blood & gastric fluids • Prevent infection & atelectasis

  4. Basic Principles • Sterile technique • hyperoxygenation and hyperinflation • Keep it short • Adult: <15 sec • Peds: <5 sec

  5. Indications for Suctioning(CMs lower airway obstruction) • Hear secretions in airway • Inspiratory wheezes, expiratory crackles • Restlessness, esp. when accompanied by decreased O2 saturation • Decreased LOC/change in mental status • Ineffective coughing • Tachypnea • Tachycardia or bradycardia • Diminished ability to cough up secretions • Client asks

  6. Nursing Care (critical elements) • Assess q2h, Suction prn • Sterility • Systemic hydration, humidification of inspired air • Safety measures – prevent decannulation • Obturator & new trach at bedside • Cuff – minimal pressure

  7. Technical Considerations • Duration < 15 sec • Preoxygenate • Rest between passes • No suction when going in • Intermittent suction coming out • Appropriate catheter size & length • Saline lavage – controversial!!! • Replace supplemental oxygen

  8. Which Catheter?How Much Suction? Suction(mm/Hg) • Adult 100-120 • Infant/Child: 50-75 (Craven & Hirnle) • Neonate: 60-80 (McKinney) Catheter Size • 5-14 French • ½ diameter of trach tube

  9. Inner Cannula-disposable • Purpose: secretion accumulation can cause obstruction • Get replacement inner cannula • Non-sterile glove • Usually suction first • Usually once/day • Remove old • Put in new, and tighten

  10. Site Care • Usually once/shift • NS or ½ strength H2O2 • Clean inferior portion under faceplate, then superior section • Rinse H2O2, then dry. • Pre-cut dressing

  11. Risk for Infection • Hospital-acquired pneumonia • Stoma infection • Interventions:

  12. Risk for airway obstruction • r/t thick secretions or mucus plug • cuff overinflation

  13. Accidental decannulation • Forceful cough • While changing trach ties

  14. Tracheal wall necrosis or stenosis • Overinflation of cuff • Long term cuff against tracheal wall • NG tube

  15. Other complications Subcutaneous emphysema • Air in subcut tissues • Not dangerous: watch for increase • Inform MD if new Ineffective Communication • Word board • Often can write • Allow time – frustrating! • “talking trach”

More Related