An endotracheal tube is a breathing tube. An airway catheter inserted into the trachea (windpipe) via the mouth or nose in endotracheal intubation. It is used temporarily for breathing because it keeps your airway open.
Purpose:
- To maintain a secure and patent airway.
- Prevent aspiration of secretions.
- To minimize oral trauma and tracheal erosions by moving the tube from side to side.
6. Tape. Carefully remove tape from ET tube and patient's face.
If tape is difficult to remove, moisten with (soapy) wet washcloth, water, or adhesive tape remover.
7. Commercial device. Remove Velcro strips; remove ET tube holder from patient.
8. Remove secretions or adhesive from patient's face. Use adhesive remover if needed.
9. Remove oral airway or bite-block, if present, and place on towel.
10. Clean mouth, gums, and teeth opposite ET tube with non–alcohol-based mouthwash solution and 4 x 4 inch gauze, sponge-tipped applicators, or saline swabs.
Brush teeth as indicated. If necessary, administer oropharyngeal suctioning. Oral ET tube only: Move ET tube to opposite side or center of mouth. Do not change tube depth.
11. Repeat oral cleaning on opposite side of mouth.
12. Clean face and neck; then rinse and dry. Shave male patient as necessary.
13. Secure ET tube.
14.Clean oral airway in warm soapy water; rinse well. Remove crusted secretions with hydrogen peroxide. Rinse with mouthwash. Shake off excess water. Reinsert oral airway and secure with tape.
15.Discard or store used items appropriately.
16.Reposition patient.
17. Perform hand hygiene.
A tracheostomy is a medical procedure—either temporary or permanent—in which a tube is surgically implanted into a person’s windpipe so that he or she can breathe.
Purpose:
- Maintain airway patency by removing mucus and encrusted secretions.
- Promote cleanliness and prevent infection and skin breakdown at stoma site.
The End
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Malaybalay Polymedic General Hospital
Malaybalay City, Bukidnon
Endotracheal Tube
and
Tracheostomy Care
Tracheostomy Care
Endotracheal Tube Care
- PPE
- Wet and dry face cloth
- Bite lock/Mouth guard
- Adhesive tape or commercial device
- Suction catheter
- Brush
- Non-alcohol-based mouthwash solution
- 4x4" gauze
- Sponge tip applicator
- Normal Saline Solution
What to Prepare?
- Sterile tracheostomy care kit containing:
- Two basins
- Small brush or pipe cleaners
- 4" × 4" gauze
- Twill tape or tracheostomy ties
- Hydrogen peroxide
- Normal saline
- Sterile gloves
- Scissors
- Tracheostomy suction supplies
Procedures:
1. Place towel over chest of patient in supine or semi-Fowler position.
Perform hand hygiene. Apply face shield if indicated.
2. Administer endotracheal suction. Connect oral suction catheter to suction source.
3. Prepare method of securing ET tube.
4. Commercial device.
5. Apply gloves. Instruct helper to put on gloves and hold ET tube firmly at patient's lips. Note number marking on ET tube at gum line.
16. Pat moist surfaces dry with 4" × 4" gauze.
17. Place dry, sterile, precut tracheostomy dressing around tracheostomy stoma and under faceplate. Do not use cut 4" × 4" gauze.
18. If tracheostomy ties are to be changed, have an assistant don a sterile glove and hold the tracheostomy tube in place.
19. Cut a 12-inch slit approximately 1 inch from one end of both clean tracheostomy ties.
This is easily done by folding back on itself 1 inch of the tie and cutting a small slit in the middle.
20. Remove and discard soiled tracheostomy ties.
7. Remove oxygen source. The hand that touches the oxygen source is no longer sterile.
8. Unlock inner cannula by turning counterclockwise. Remove inner cannula.
9. Place inner cannula in basin with hydrogen peroxide
10. Replace oxygen source over or near outer cannula.
11. Clean lumen and sides of inner cannula using pipe cleaners or sterile brush
12. Rinse inner cannula thoroughly by agitating in normal saline for several seconds
13. Remove oxygen source and replace inner cannula into outer cannula. "Lock" by turning clockwise until the two blue dots align
14. Remove soiled tracheostomy dressing
15. Clean stoma under faceplate with circular motion using hydrogen peroxide-soaked cotton applicators.
Clean dried secretions from all exposed outer cannula surfaces
21. Bring both ties together at one side of the client's neck.
Assess that ties are only tight enough to allow one finger between tie and neck. Use two square knots to secure the ties. Trim excess tie length. Note: Assess tautness of tracheostomy ties frequently in clients whose neck may swell from trauma or surgery.
22. Remove gloves and discard disposable equipment. Label with date and time, and store reusable supplies.
23. Assist client to comfortable position .
24. Wash hands.document assessment and completion.
5. Replace oxygen or humidification source
6. Open sterile tracheostomy kit . Pour normal saline into one basin, hydrogen peroxide into the second . Don Sterile gloves . Open several sterile cotton-tipped applicators and one sterile precut tracheostomy dressing and place on sterile field . If kit does not contain tracheostomy ties, cut two 15-inch pieces of twill tape and set aside.
1. Verify the physician order and identify the client.
2. Wash your hands and don gloves.
3. Explain procedure to client.
Place the client in semi- to high Fowler's position
4. Suction tracheostomy tube. Before discarding gloves, remove soiled tracheostomy dressing and discard with catheter inside glove. When suctioning through a tracheostomy tube, insert catheter about 10 to 12 cm (in an adult).
Procedure: