Tracheostomy

OM Nursing Academy

Anil Kantiwal Gudha ( WhatsApp 9694936335 )

Introduction :-

Tracheostomy एक Surgical Procedure ह जसम Trachea म Arteficial incision के ारा

Tracheostomy tube insert करवाते
ह जससे Patient म एक Patent ( Open ) Airway बना सके
।

Indications :-

 Upper Airway Obstruction due to Foreign body, edema, tumor & Stenosis.

 Respiratory failure

 Neurological disorder of diaphragm

 Severe Extensive Burn

 Any condition in which endotracheal tube cannot be inserted.

Classification :-

1. Emergency & Prophylactic

2. Temporary & Permanent

3. High ring ( 1st & 2nd ) & Low ring ( 3rd & 4th )

Types of Tracheostomy Tube :-

A. Double lumen & Single lumen structure

1. Outer Cannula

2. Inner Cannula

3. Obturator / Pilot

B. Cuff & Non Cuff Tracheostomy

C. Fenestrated & Non fenestrated :-

 Fenestrated Tracheostomy Tube known as " Talking Tracheostomy Tube ".

Procedure :-

1. Position - Rose Position ( Supine with

Hyperextension of Neck )

2. Incision at 2nd - 3rd Ring

3. After Tracheostomy give Fowler position.

4. Suctioning
Suctioning :-

 Suctioning should not be continued more than 5 to 10 seconds.

 Prolonged Suctioning will Cause Hypoxia & Bradycardia ( Cardiac arrest ).

 Suctioning करने
सेपहले
Patient को 100% O2 से
HyperOxygenated करना चा हए .

Suction Pressure :-

 Preterm Baby :- 40 - 60 mm of Hg

 Infant :- 60 - 80 mm of Hg

 Child :- 80 - 100 mm of Hg

 Adult :- 100 - 120 mm of Hg

Suction Catheter Size :-

 Infant :- 5 - 8 Fr.

 Child :- 8 - 10 Fr.

 Adult :- 12 - 18 Fr.

 Apply Suctioning intermittently while rotating & Withdrawing Catheter.

5. Time :-

1. First 24 hours :- After every 30 minute

2. After then :- every 2 hour

6. Decannulation :- tracheostomy tube को remove करना ।

7. 2 - 4 घ टे
बाद inner cannula को H2O2 , NaHCO3 , 0.9 % NS से
clean कर

8. Stoma को Clean रख एवँ

Antibiotic Ointment व वे
से
लन गॉज का use कर ।

Complications of Tracheostomy :-

 Tracheomalacia :- Tracheal dilation & Erosion

 Tracheal Stenosis

 Tracheo Esophageal fistula

 Tube Obstruction and Dislodgement.

Anil Kantiwal Gudha

OM Nursing Academy
WhatsApp No. 9694936335

E-mail- anu.kantiwal.gudha@gmail.com

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