VIEW THE MOBILE VERSION of www.homemedicine.ca Informational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Alcohol

The patient is quite helpless, and there is usually a strong s...

Papilloma Forceps

Papillomata do not infiltrate; but superficial repullulation...

Appetite

Should be an indication that food in general or some certain k...

How To Get And Keep A Good Figure

Erect Position is the Result of Vigorous Health. Naturally an...

Paracelsus

THEOPHRASTUS BOMBASTUS VON HOHENHEIM, commonly known as Parac...

Varioloids And Chicken-pocks

_Varioloids_ and _Chicken-pocks_, are treated in the same man...

Tuberculosis Of The Esophagus

Esophageal tuberculosis is not commonly met, but is probably ...

Gatherings

See Abscess; Ankle; Armpit; Bone, Diseased. ...

The Anti-gastric Method

consisting in the free use of emetics or purgatives, has been...

Notes On Nursing Tracheotomized Patients

Bedside tray should contain: Duplicate cannula Scalpel ...

Relaxation Of Treatment Towards The End Of The Third Period Continuation Of Packs During And After Desquamation

When the patient is through the first part of the period of ...

The Distinctive Diagnosis Between External And Internal Inguinal Herniae The Taxis The Seat Of Stricture And The Operation

A comparison of the relative position of these two varieties ...

What Kind Of Food Should We Eat?

Generally speaking, our Appetites will Guide us. Our whole bo...

Electrical Classification Of Diseases

There are two, and only two, primary classes of disease--thos...

The Development Of Allergies

There are three ways a body can become allergic. (1) It can h...

Sensitiveness

When the nervous system is in a certain state, all impressions...

Ringworm

This distressing and most infectious trouble is due to a small...

Polypus

See Nostrils. ...

The Surgical Dissection Of The Superficial Structures Of The Male Perinaeum

The median line of the body is marked as the situation where ...

Shock

The treatment of shock will probably always be unsatisfactory...



Resume Of After-care Of A Tracheotomic Case





Category: TRACHEOTOMY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

1. Always bear in mind that tracheotomy is not an ultimate object.
The ultimate object is to pipe air down into the lungs. Tracheotomy is
only a means to that end.
2. Sterile tray beside bed should contain duplicate (exact)
tracheotomy tube, Trousseau dilator, hemostat, thumb forceps, silver
probe, scissors, scalpel, probe-pointed curved bistoury. Sterile
gloves ready.
3. Special nursing necessary for safety.
4. Laxative.
5. Sponge away secretions before they are drawn in.
6. Cover wound with wide large gauze square slit so it fits around
cannula under the tape holder. Pull off ravelings. Keep wet with
1 : 10,000 Bichloride solution.
7. Change dressing every hour or oftener.
8. Abundance of fresh air, temperature preferably about 70 degrees.
9. Nurse should remove inner cannula as often as needed and clean
it with pipe cleaner before boiling.
10. Outer cannula should be changed every day by the surgeon or
long-experienced tracheotomy nurse. A pilot should be used and care
should be taken not to injure the cut ends of the tracheal cartilage.
11. A sterile, bent probe may be inserted downward in the trachea
with both cannulae out to excite cough if necessary to expel
secretions. An aspirating tube should be used, when necessary.
12. A patient with a properly fitted cannula free of secretions
breathes noiselessly. Any sound demands immediate attention.
13. If the respiratory rate increase it is much more likely to be
due to obstruction in, malposition of, or shortness of the cannula
than to lung complications.
14. Be sure that:
(a) The cannula is clear and clean.
(b) The cannula is long enough to reach well down into the
trachea. A cannula that was long enough when the operation was done
may be too short after the cervical tissues swell.
(c) The distal end of the cannula actually is deeply in the
trachea. The only way to be sure is, when inserting the cannula, to
spread the wound and the tracheal incision with a Trousseau dilator,
then see the interior of the tracheal lumen and see the cannula
enter therein.
15. If after attending to the above mentioned details there are
still signs of obstructive dyspnea, a bronchoscopy should be done for
finding and removal of the obstruction in the trachea or main bronchi.
16. If all the pipes, natural and instrumental, are clear there
can be no such thing as obstructive dyspnea.
17. Pneumonia and pulmonary edema may exist before tracheotomy, but
they are rare sequelae.
18. Decannulation, in cases of tracheotomy done for temporary
conditions should not be attempted until the patient has slept at
least 3 nights with his cannula tightly corked. A properly fitted
cannula (i.e. one not larger than half the area of cross section of
the trachea) permits the by-passage of plenty of air. A partial cork
should be worn for a few days first for testing and weaning a child
away from the easier breathing through the neck. In cases of chronic
laryngeal stenosis a prolonged test is necessary before attempting
decannulation.
19. A tracheotomic case may be aphonic, hence unable to call for
help.
20. The foregoing rules apply to the post-operative periods. After
the wound has healed and a fistula is established, the patient, if not
a child, may learn to care for his own cannula.
[298] 21. Do not give cough-sedatives or narcotics. The cough reflex
is the watch dog of the lungs.





Next: Notes On Nursing Tracheotomized Patients

Previous: Resume Of Emergency Tracheotomy



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 1396