SF Nursing Trach Care  Part 1 Suction
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SF Nursing Trach Care Part 1 Suction

– Hello, welcome to Santa
Fe College nursing labs. Today I’m gonna be
demonstrating tracheostomy care. There are gonna be two
parts to this video. Part one is gonna include
the suctioning of the trach and part two will include the changing of the inner cannula or washing of the inner cannula including changing the dressing below the tracheostomy. We need to make sure that we have the correct equipment in the room in order to do tracheostomy
care and suctioning. We have out a workstation on wheels, which we use to check the order. We have the suction canister
and suction machine. We also have out ambu bag, which is attached to an oxygen source. Any patient with a tracheostomy needs to have a new tracheostomy at bedside. It needs to have the new trach including the obturator in place,
so that in an event of an emergency where the
current trach is dislodged, there is a new one that
is the correct size right at bedside. I have gathered my supplies,
checked my doctor’s order and now it’s time to enter the room. Sanitize, wash my hands. Hello Mrs. Jones, how are you doing today? I’m gonna introduce myself to the patient. I am gonna ask her to state
her first and last name as well as her date of birth. I am gonna double check her arm band that she is the correct patient. I am gonna explain to the patient what we are gonna do and
then I am gonna double check the room for all the necessary equipment. So, Mrs. Johnson, I am gonna go ahead and suction your trach and
I’m just gonna make sure I have all of the necessary equipment. I’m checking I have my ambu bag, which is attached to oxygen. I can go ahead and turn
my oxygen on as well now. I’m gonna remove the one tie on the trach tent in order to make it easier for myself to move later on with one hand. I can see that she has a new tracheostomy including obturator at bedside. I’m gonna go ahead and check my suction machine and canister. For suctioning a tracheostomy it is recommended that you are between 80 and 100
millimeters of mercury, which I am. Next I need to raise the patient up to a height that is comfortable for me. When I do tracheostomy suctioning I also need to raise the head of the bed and make sure that the patient is at a 45 degree angle. Before I suction the patient I need to listen to the breath sounds. If you need a review
listening to breath sounds, please watch the physical
assessment video. Usually breath sounds are listened to under the gown. You do not want to listen over the gown. But for the purpose of the video I’m gonna be listening over the gown. Next I’m gonna move my supplies closer to the patient in order
to start suctioning. I’m gonna lower this rail
so I do not hurt my back. The supplies that you need to
do trach suctioning include sterile normal saline or sterile water, a sterile container in
order to check your suction, sterile suction catheter,
and then I have two pairs of sterile gloves. You always bring extra gloves in case you contaminate by accident. The first thing I’m gonna
do to get my supplies ready is fill up my sterile container. I’m gonna open the cap. Put the cap upside down. When you’re opening a new bottle of normal saline or sterile water you want to make sure that
the bottle is within date, that it has not expired. If you are the first
person opening this bottle you also want to label it with the date and time and your
initials when you open it. Most hospital policies are after 24 hours this bottle is considered non-sterile and has to be thrown out. I’m gonna loosen my cap. The cap goes face up. When I hold my bottle, I
want my palm on the label so that you avoid dripping any liquid onto the label. I’m just gonna pour a little bit of normal saline or
sterile water into my cup. Again then replace the cap. I am then gonna want to
open up my suction catheter, maintaining sterility. I then need to put my sterile gloves on. I am right handed, so my
right glove goes on first. Pick up, step back. I’m then gonna put on my left glove. Step back from the table. My hands are, at the
moment, still sterile. I’m gonna go ahead and pick
up my sterile suction catheter and I want to wrap this
around my dominant hand, which for me is my right hand. I want to hold it in this position. I am now purposely gonna
contaminate my left hand. I have to reach for my suction tubing without touching my left and my right hand I need to attach the suction catheter to the tubing. This hand and the end part
of the suction catheter is now contaminated and
not considered sterile. I’m gonna go ahead and check to make sure my catheter and suction is working, without touching the edges. I’m gonna go ahead now and wrap the catheter back around my hand in order to remain sterility. I have wrapped the
catheter around my hand, I am then gonna go ahead
and remove the mist collar. Before we suction we need to
hyperoxygenate the patient. You can do this a couple
of different ways. If the patient is able
to, you can ask them to take two to three deep breaths in. If the patient is ventilated you can use the sign mechanism. If the patient is not ventilated you can also attach an ambu bag to oxygen and when they breath in
you can deflate the bag to help increase their inspiratory volume. I’m gonna go ahead and
hyperoxygenate my patient. So take a deep breath in. Good and another deep breath. And one more. Excellent. Now I’m gonna go ahead
and suction the patient. We are only suctioning
as long as the trach. We do not put the suction catheter all the way down until
it meets resistance. We do not want to damage the airway. When inserting the catheter, you do not have the suction on. Only when withdrawing the catheter. The patient may cough as I’m withdrawing the catheter and suctioning. When you are withdrawing
the suction catheter, you want to twist in order to get all the surfaces of the tracheostomy tube. Your patient may cough
when you’re suctioning. I’m gonna go ahead and just
clear my suction tubing. Depending on your patient, you may need to suction again or you may not suction. You can at this point
double check breath sounds before you suction again. Or if when you first listened to them and they sounded really junky and you know you need to suction again or you got a copious amount of fluid out, you would want to suction
a second or third time. Since we are not gonna suction again for this patient, I’m gonna go ahead and replace my mist collar. I’m gonna disconnect my suction catheter from my suction tubing. I can then turn off my suction machine. My gloves can now come off and I can throw my catheter away. I want to make sure that
I replace my trach tent appropriately, that it is nicely secured over the patient’s trach. That is the end of part one. Next up will be part two where we will be cleaning the inner cannula and cleaning around the dressing site.

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23 thoughts on “SF Nursing Trach Care Part 1 Suction

  1. excellent, im taking care of my mother and you had help me even better then her own doctors. thank you so much.

  2. Depth of sunctioning is so important, generally 2 cms more than trachy size otherwise you are just causing discomfort and damage, and fear in the patient! Trachy size and depth of suctioning is so important!

  3. Excellent vedio but one thing which need to improve that when ever touch patient need to wear glove….
    Thank u and keep it up…

  4. It’s a great video with good content but the suction catheter when inserted inside shouldn’t be moved round i guess because it makes the patient cough and can hurt them.
    and if the suction catheter is folded round like she did in her hands, is suction is 100%?

  5. Need to wear glove when touching trach area and need to wash/sanitize hands in b/n touching pt/things and before wearing gloves

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