Aliya Health Care Nursing Services provide tracheostomy care staff for clients with a new or recent tracheostomy to maintain patency of the tube and minimize the risk for infection (since the inhaled air by the client is no longer filtered by the upper airways). Initially, a tracheostomy may need to be suctioned and cleaned as often as every 1 to 2 hours. After the initial inflammatory response subsides, tracheostomy care may only need to be done once or twice a day, depending on the client.
Our Staff Supervision & Monitoring
In determining the level of supervision and monitoring which is required, it is recommended each patient with a tracheostomy is assessed on an individual basis by the treating medical/surgical and nursing team4 taking into consideration the following factors.
Age-specific alarm limits
Nature of the airway problem
Ability to breathe and maintain their airway in the event of accidental decannulation
Ability to clear own secretions
The frequency of suction/tracheostomy tube interventions required
Monitoring may include
Heart rate +/- continuous cardiac monitoring
Pulse oximetry continuous/overnight
Work of breathing
Behaviour - alert, irritable, lethargic
Suctioning of the tracheostomy tube is necessary to remove mucus, maintain a patent airway, and avoid tracheostomy tube blockages. Indications for suctioning include
Audible or visual signs of secretions in the tube
Signs of respiratory distress
Suspicion of a blocked or partially blocked tube
Inability by the child to clear the tube by coughing out the secretions
Changes in ventilation pressures (in ventilated children)
Request by the child for suction (older children)
Tracheal suctioning should be carried out regularly for patients with a tracheostomy tube. However, the frequency varies between patients and is based on individual assessment.
Tracheal damage may be caused by suction. This can be minimized by using the appropriately sized suction catheter and only suctioning within the tracheostomy tube.