Home Nursing Care Of Tracheostomy Patient | Tracheostomy Care Nursing – Care24

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Tracheostomy is a procedure that helps in creating a surgical airway in the cervical trachea. It is usually performed in patients who have difficulty weaning  ventilator, followed by those who have suffered from any trauma or a catastrophic neurologic insult. Neoplasticism and infectious processes are less common in diseases that require a surgical airway.

Tracheostomy is a surgical procedure of access; therefore, it should be discussed in respect of the problem it addresses: access to the tracheobronchial tree. The trachea is a passage between the upper airway and the lungs that delivers moist warm air and expels carbon dioxide and sputum. Failure or blockage of it at any point can be most readily corrected with the provision of access for mechanical ventilators and suction equipment. In the cases of upper airway obstruction, tracheostomy helps in providing a path of low resistance for air exchange.

Difference between tracheostomy and tracheotomy 

A tracheostomy which is also called tracheotomy,  is an opening which is surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done under general anesthesia. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.

Early Complications which may arise just after the tracheostomy procedure include:

• Bleeding
• Air gets trapped around the lungs (pneumothorax)
• Air found trapped in the deeper layers of the chest(pneumomediastinum)
• Air trapped underneath the skin around the tracheostomy called as subcutaneous emphysema.
• Damage to the swallowing tube (esophagus)
• Injury to the nerve which moves the vocal cords.
• Tracheostomy tube blocked by blood clots,pressure or mucus of the airway walls.
• Any type of Blockages can be prevented by suctioning, humidifying the air, and selecting the appropriate tracheostomy tube.

Many of these early complications can be dealt or avoided with appropriate help with our experienced surgeons.

Later Complications that may show up while the tracheostomy tube is in place, include:

• Accidental removal of the whole or part of  tracheostomy tube, accidental decannulation.
• Infection occurring in trachea and around the tracheostomy tube
• Windpipe itself may become damaged.

These complications can be prevented or quickly relieved with if the caregiver has proper knowledge of how to care for the tracheostomy site.

High-risk groups

The other risks associated with tracheostomies are higher in the following groups of patients:

• children, especially newborns and infants
• smokers
• alcohol abusers
• diabetics
• immunocompromised patients
• persons with chronic diseases or respiratory infections
• persons taking steroids or cortisone

A tracheostomy is usually done to cure one of several reasons:

• It is done to bypass an obstructed upper airway
• Also performed to clean and remove secretions from the airway;
• Prolonged mechanical ventilation (breathing machine); and
• To more easily, and usually more safely, deliver oxygen to the lungs.

Patients are able to enjoy a good lifestyle with a permanent tracheostomy tube. However, some people find it difficult to adapt to breathing and communication.

Physical activity

One should be able to continue everyday activities, but you should avoid vigorous activities for about six weeks after the procedure.

Speech

Speaking is a difficult task after having a tracheostomy. After tracheostomy is  done, one should refer to language and speech therapist who will help to give you further advice and training in speaking while the tube is still inserted so that you can improve your ability to communicate.

Our surgeon monitors the healing for several days after the tracheostomy. The initial tube placed at the time of surgery will be changed to a new tube between 10 and 14 days following surgery. Tube is changed subsequently by the treating physician or nursing staff.

Mainly, Speech will be difficult until the time comes for a special tube to be placed. Once the-size of the tube is decreased, speaking may be possible. At the appropriate time, instructions will be given. Oral feeding will also be difficult until a smaller tube is placed.

If the tracheostomy tube will be necessary for a long period of time, the patient and family will be helped with home care. This will include suctioning of the trachea, changing and cleaning of the tube.

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