Tips for Caregivers: Handling Tracheostomy Equipment with Confidence
Have you ever felt anxious or overwhelmed when handling equipment or caring for someone with a tracheostomy? You’re not alone. In fact, many nurses and even doctors tend to feel a tad bit apprehensive at first. That doesn’t mean you can’t learn the right skills to feel confident!
Whether the tracheostomy performed is a permanent or a temporary one, proper handling of equipment and a consistent maintenance routine is essential for the patient’s comfort as well as to avoid complications. Here are five core areas caregivers should focus on;
1. Educate Yourself on the Basics
The first step of the ladder should be ensuring you understand everything about the equipment and its function. A tracheostomy procedure is one that involves pushing a tube through a surgical opening in the neck, into the trachea, allowing air to bypass the upper airway.
Tube types vary. Depending on whether you need a cuffed or uncuffed tube and whether you need it to be disposable or reusable, each type requires specific kind of care.
It would do you well, and save you a lot of end-moment panic, if you begin familiarizing yourself with the terms including outer cannula (the main tube), inner cannula (this may be removed for cleaning), and obturator (used when the tube is inserted).
It’s much more than just handling the equipment. One must know how the body will adapt to breathing through the tracheostomy. The body may lose the humidification and filtering that is normally performed by the nose.
Pro Tip: Attend training sessions with expert respiratory therapists or nurses, and watch demonstration videos published by verifiable medical sources. You could also read the manufacturer’s instructions in great depth to get the kind of competence and clarity you need to care for your tracheostomy patients effectively.
2. Encourage a Safe and Sterile Environment
Infection is one of the most common issues that can result from tracheostomy care. To reduce the level of risk, you must maintain a certain level of cleanliness. Invest in high quality tracheostomy equipment and, before you begin handling any of it, don’t forget to wash the hands with soap and water, or an alcohol-based sanitizer.
Similarly, when you are engaging in tasks such as changing dressings, don’t forget to pick up sterile gloves and supplies only. Always clean the surface where the equipment is placed to prevent any cross contamination.
Expect the cleaning of the inner cannula task to be requested on a routine basis. Although you might get used to it after a while and the process might seem monotonous, do it with the utmost attention and precision. Reusable cannulas are usually cleaned with milder solutions like hydrogen peroxide diffused with saline and disposable cannulas are replaced. The more often and more religiously this is done, the better the infection prevention.
3. When Does the Parent Need Suction
You must learn to keep the airway clear of any secretions that the individual might not have been able to cough or throw up previously. While some patients might require suctioning multiple times a day, others may use it every once in a while.
Know the signs. Noisy breathing, visible mucus in the tracheostomy tube, or sudden restlessness; all these are signs that something is wrong.
The process of suctioning should be gentle but fast. You must begin the act by inserting that catheter without the suction and only apply suction when you withdraw it. You must withdraw in slower, rotating motions and suction should never be done beyond 10-15 seconds at a time as overly using it can reduce oxygen levels in the patient’s brain or irritate the airway.
Between each pass, you can allow time for the patient to recover, especially if they are showing signs of distress.
4. Humidification and Hydration
These are two great components that should be learned and implemented by every caretaker looking after patients with a tracheostomy. Since the tracheostomy is supposed to bypass the natural humification process of the upper airway and maintain adequate moisture in the airway, a humidifier can be used to ensure proper airway hydration.
You must also focus on keeping them hydrated. The more you encourage fluid intake (where it is medically appropriate of course) the easier it is for them to maintain thinner secretions. It also lessens their need for frequent suctioning. This is especially needed if they’re exposed to hotter climates or during periods of illness where the risk of dehydration increases.
5. Stay Prepared for Emergencies
Emergencies like accidental decannulation (tube dislodgement) can occur quite suddenly and would be frightening enough for experienced professionals, let alone for first time caregivers.
Keep an emergency kit nearby at all times to stay prepared, including spare tracheostomy tubes of the same size as well as one size smaller. These should accompany an obturator, lubricant, scissors, sterile gloves, and a manual resuscitation bag just in case.
Final Tips
Monitor the site as well as the patient for complications. Report any redness, swelling, foul odor, unusual discharge, or increased coughing immediately as it may point to an infection.
The better your training, and the more invested you are in your education, the more confident you’ll be when managing tracheostomy equipment. Good luck!
