Caring for patients undergoing tracheostomy in the ICU

Article by Doctor Nguyen Ngoc Phuong Nam - Emergency Resuscitation Doctor - Emergency Resuscitation Department - Vinmec Central Park International General Hospital

Caring for a tracheostomy patient is a job that needs special attention to protect the best health of the patient. Caregiving includes aspiration of sputum, dressing change, tracheostomy lavage, cannula replacement or cleaning, and local anti-infection nebulizer.

Tracheostomy is inserting an instrument (Canuyn) into the trachea to create a tunnel for air to enter the lungs without going through the nasopharynx. This tracheostomy may be temporary or permanent. In the case of a long-term tracheostomy, care must be taken very carefully to avoid infection.
Indications for tracheostomy include:
Maintain airway. Long-term intubation (>7-10 days). Persistent upper airway obstruction (eg, due to maxillofacial). Laryngeal disease. Subglottic stenosis. Protect airways Slow recovery of glottis reflex Tracheal hygiene/ineffective cough action.

Care of the tracheostomy includes: changing the dressing daily or when there is a lot of discharge, washing the tracheostomy, changing the cannula (or cleaning it), diet, activities, physical therapy suitable.
The care of patients with tracheostomy should be done in a methodical manner, with a plan for the patient to recover in the best way.

In the care of patients with tracheostomy, special attention should be paid to the following:
The patient is regularly aspirated when there is a lot of sputum in the lungs, or the patient can spit out the sputum through the hole. tracheostomy. Change the dressing, wash the tracheostomy incision once a day. Observe the condition of the skin around the tracheostomy when changing the dressing, look for signs of the skin around the tracheostomy, swelling, redness, bleeding, pus... Check the position of the tracheostomy tube, check the wire The tracheostomy column is properly tied (fits 2 fingers), re-examination as soon as the tracheostomy tube is found to fall or fall out. Check the color and nature of viscous sputum in the tracheostomy tube every time the dressing is changed. It is recommended to use a "air filter" prosthetic lung to humidify the air, to avoid causing dryness leading to thick sputum that is difficult to spit and clean.

The replacement must be done by a doctor at a hospital or clinic with adequate emergency equipment. Normally, it will be changed every 3 months or when there are signs of blockage Canuyn
Change 1 barrel to 2 barrel type when training the patient to breathe through the nose on their own or can practice talking for the patient

Patients will be assigned to eat according to the needs of the disease, increase vegetables and vitamins. The “Air Filter” prosthetic lung should be used to humidify the air.
When sleeping, be careful not to let blankets or bed sheets block the airways. During bathing, personal hygiene should cover the breathing hole and be careful not to let water splash into the airway.
Patients are given respiratory therapy exercises taught by physiotherapists to help improve breathing problems, which can speed up the complete recovery of respiratory problems as well as have The tracheostomy can be removed as soon as possible
Care of the tracheostomy in the ICU is not too difficult a technique, but it is very meticulous and thorough to avoid infection and speed up patient recovery. Patients and relatives can still take care of the tracheostomy when they return home with the guidance of medical staff. However, it is necessary to have a clear and detailed care plan for tracheostomy patients to ensure the best health. Patients should be examined and treated at reputable hospitals so that complications can occur if the tracheostomy is not cleaned properly. Vinmec International General Hospital is a high-quality medical unit in Vietnam, with a team of well-trained, specialized doctors at home and abroad, with high qualifications and experience.
Modern medical equipment, imported in the US, Japan, the Netherlands... supports the most effective diagnosis and treatment of diseases. Treatment techniques at Vinmec are regularly and continuously updated, keeping up with new trends of world health, providing the most effective treatment regimens.