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Notes On Nursing Tracheotomized PatientsCategory: CHRONIC STENOSIS OF THE LARYNX AND TRACHEA Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery Bedside tray should contain: Duplicate cannula Scalpel Trousseau dilator Hemostat Dressing forceps Sterile vaseline Scissors Tape Probe Gauze sponges Gauze squares Probe-pointed curved bistoury. 1. Room should be abundantly ventilated, as free from dust and lint as possible, and the air should be moistened by steam in winter. 2. Keep mouth clean. Tooth brush. Rinse alcohol 1:10. 3. Sponge away secretion after the cough before drawn in. 4. Remove inner cannula (not outer) as often as needed. Not less often than every hour. Replace immediately. Never boil a cannula until you have thoroughly cleaned it. 5. Obstruction of cannula calling for cleaning indicated by: Blue or ashy color. Indrawing at clavicles, sternal notch, epigastrium. Noisy breathing. (Learn sound.) 6. Surgeon (in our cases) will change outer cannula once daily or oftener. 7. Duplicate cannulae. 8. Be careful in cleaning cannulae not to damage. 9. Watch for loose parts on cannula. 10. Change dressing (in our cases) as often as soiled. Not less often than every hour. Large squares. Never narrow strips. 11. Watch color of lips and ears and face. [299] 12. Report at once if food or water leaks through wound. (Coughing and choking). 13. Never leave a tracheotomized patient unwatched during the first days or weeks, according to case. 14. Remember Trousseau dilator or hemostat will spread the tracheal wound or fistula when cannula is out. 15. Remember life depends on a clear cannula if the patient gets no air through the mouth. 16. Remember it takes very little to clog the small cannula of a child. 17. Remember a tracheotomized patient cannot call for help. 18. Decannulation. Testing by corking partially. Watch corks not too small, or broken. Attach them by braided silk thread. Pure rubber cord ground down makes best cork. Next: Chronic Stenosis Of The Larynx And Trachea Previous: Resume Of After-care Of A Tracheotomic Case
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