Module Title:Tracheostomy Care**Successful completion of the “Sterile Technique” module is required prior to this module.**

Trach CareDefinition of Tracheotomy:A surgical procedure to create an opening into

the neck through which to breathe.Performed for airway obstruction, which may

have many causesDefinition of Tracheostomy:The opening into the airwayDefinition of the Stoma:The opening on the skin surfaceDefinition of the Cannula:An indwelling tube inserted through the stoma to

maintain patency

Trach CareDefinition of Tracheostomy Care:Sterile ProcedurePerformed only by RN’s in most facilitiesDone to keep the stoma and cannula clean and

free from obstructionDone to prevent skin irritation and breakdownDone to prevent water and solid foreign

matter from entering the lungsDone to prevent infectionMay include suctioning of the airway

Trach Care

3 Types of Tracheostomy Tubes

Disposable/non-disposableSingle cannulaDouble cannula

Trach CarePossible reasons for needing a Trach:Neuromuscular diseases paralyzing or weakening

chest muscles and diaphragm Aspiration related to muscle or sensory problems in

the throat Fracture of cervical vertebrae with spinal cord

injury Long-term unconsciousness or coma Disorders of respiratory control such as Congenital

Central Hypoventilation or Central Apnea Facial surgery and facial burns Anaphylaxis (severe allergic reaction)

Trach CareDisposable/non-disposable Trach TubesBoth will use a face plate held in place with

ties around the neckThe inner cannula is the disposable/non-

disposable pieceAfter removing the inner cannula, the

disposable cannula will be disposed of and a new cannula will be inserted; the non-disposable cannula will be cleaned with H2O2, rinsed and re-inserted into the face plate

Trach CareSingle Cannula Trach’s consist of the outer

cannula which is attached to the face plate, and an obturator

The main parts of a double cannula tracheostomy tube are the outer tube (or cannula), the inner tube (or cannula) and the obturator. The

Trach CareReporting and Recording:Vital Signs-should be monitored before and

after the procedure and reported to the nurse if noted not within normal limits

Skin Color-if the skin is noted to be taking on a blue tint (cyanosis) or red color due to uncontrolled coughing, this should be reported to the RN immediately

Patient Response—if uncontrolled coughing, apnea, dyspnea, or short of breath- report immediately to the RN