Tracheostomy: What it is and How to care

A tracheostomy is a small hole that is made in the throat, over the trachea region to facilitate the entry of air into the lungs. This is usually done when there is an obstruction in the air path caused by tumors or inflammation of the throat after surgery, for example, and therefore can be maintained only for a few days or for a lifetime.

If it is necessary to maintain the tracheostomy for a long time, it is important to know how to care properly, to avoid serious complications such as suffocation or even a possible lung infection. This care can be done by the caregiver, when the person is bedridden, or by the patient himself, when he feels capable.

What to do to treat tracheostomy

To avoid the risk of serious complications it is important to keep the cannula clean and free of secretions, as well as to change all components according to the doctor’s instructions.

In addition, it is essential to observe whether the tracheostomy site is red or swollen, because if you present these signs it may indicate the appearance of an infection, which should be immediately reported to the doctor.

1. How to keep the cannula clean

To keep the tracheostomy cannula clean and free of secretions, which can cause asphyxiation or infections, you must:

  1. Put on clean gloves;
  2. Remove the inner cannula and place it in a container with soap and water for 5 minutes;
  3. Aspirate the inside of the outer cannula with a secretion aspirator. If you do not have a secretion aspirator, you can inject 2 mL of saline into the outer cannula, causing coughing and helping to remove accumulated secretions in the airways;
  4. Place a clean and sterile inner cannula;
  5. Rub the dirty inner cannula, inside and out, using a sponge or brush;
  6. Place the dirty cannula in boiling water for about 10 minutes;
  7. Dry the cannula with sterile compresses and store in a container disinfected with alcohol, to be used in the next exchange.

The outer cannula of the tracheostomy should only be replaced by a health professional, as there is a great risk of suffocation when done at home. Thus, one should go to the hospital at least once a week to change the entire tracheostomy set, or as instructed by the doctor.

2. How to change the padded surface

The cushioned surface of the tracheostomy should be changed whenever it is dirty or wet. After removing the dirty cushioned surface, clean the skin around the tracheostomy with a little saline and apply a little unscented moisturizer.

To place a new pillow, you can use pads suitable for tracheostomy, as shown in the first image, or use 2 clean compresses with a cut on the top, as shown in the second image.

How the tracheostomy is performed

Tracheostomy is done through surgery at the hospital with general anesthesia, although in some cases the doctor may also choose local anesthesia, according to the difficulty and duration of the process.

Then, a small cut is made in the throat to expose the trachea and a new cut is made in the cartilage of the trachea, to allow the tracheostomy tube to pass. Finally, in the first phase or if the person only needs a tracheostomy at the hospital, machines are connected to help breathe.

Although you can go home with a tracheostomy, this procedure is generally used more in people with more serious problems who need to stay in the ICU for a long time, for example.

Warning signs to go to the doctor

Some signs that indicate that you should go immediately to the hospital or emergency room are:

  • Clogging of the external cannula by secretions;
  • Accidental exit of the external cannula;
  • Bloody sputum;
  • Presence of signs of infection, such as redness of the skin or swelling.

When the patient feels short of breath, he must remove the inner cannula and clean it properly. However, if the symptom persists, you should immediately go to the emergency room.

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