SUBJECT: Tracheostomy Care

1. Statement of Purpose

1.1. Tracheostomy is performed as a permanent or temporary therapy to

Facilitate airway patency and removal of secretions.

2. Policy

2.1 Only Registered Nurses who have completed the competency shall perform
Tracheostomy care.

2.2 Tracheostomy care is a shared responsibility between the nurse and the
Tracheostomy Team. The doctor must make a referral to the Tracheostomy
Team.

2.3 Strict aseptic technique shall be maintained with a new stoma and clean
Technique once it is completely healed.

2.4 The Nurse must ensure that a tracheal dilator is available by the patient’s
Bedside if accidental decannulations occur.

2.5 The Doctor and Respiratory Therapist are responsible for the changing of
all tracheostomy tubes an decannulation.

2.6 For Tracheostomy care procedures, refer to springhouse:

Nursing Procedure, Chapter 8, Respiratory Care.

2.6.1 1 nurse, 1RT are required to perform tracheostomy tape change

2.6.2 If oxygen is required, it must be ordered by doctor and 2.6.2.1.1.1.1
administered with humidification.
2.6.3 A doctor’s order is required for cuff inflation or deflation.

2.7 Assessment of newly formed tracheostomy stomas during the first 24 hours
Shall be as follows:

2.7.1 Every 15 minutes x 1, 30 minutes x 2, hourly.

2.7.2 Respiratory rate and symmetry of chest movement and CXR as per
2.7.3 Patency and integrity of inner cannula and sutures
2.7.4 Observe stoma site for bleeding and swelling
2.7.5 Ability to swallow
2.7.6 Assisted communication devices intact
2.7.7 Sutures shall be removed between 5-7 days as per doctor’s order

© Cassidy Rabong 2010 Prepared by: SN. CaR

http://levocetirizinedihydrochloride.blogspot.com/
 2.8 Frequently used Tracheostomy tubes:

2.8.1 Portex cuffed / uncuffed

2.8.2 Shiley fenestrated / unfenestrated
2.8.3 Trachoe

2.9. Patient discharged home with a tracheostomy tube required the following:

2.9.1 Referral to Home Support and Tracheostomy Coordinator.

2.9.2 OPD appointment for on going tracheostomy tube change

3. References

3.1. Springhouse, (1999), NURSING PROCEDURE, 3rd edition, Springhouse

Publishers.

3.2. Lippincott, (2001), Manual of Nursing Practice , 7th edition, Lippincott

William & Wilkins

© Cassidy Rabong 2010 Prepared by: SN. CaR

http://levocetirizinedihydrochloride.blogspot.com/