Tracheostomy -Care of a child under Tracheostomy : A tracheotomy is a strategy where opening is made into the trachea. At the point when an inhabiting tube is embedded into the trachea, the term tracheostomy is utilized. trachestomy may be two type temporary or permanent. trachestomy is performed to by pass upper airway hindrance, to expel tracheoborncheal discharges, to forestall aspiration of oral or gastric discharges in the oblivious or paralyzed patient and to replace an endotracheal tube. There are many disease forms and crisis conditions that make a tracheostomy necessary.
Care of a child under Tracheostomy Method:
The method is acted in the operating room or in an emergency unit, the patients condition can be well controlled an optimal aseptic method can be maintained. opening is made in second or third tracheal rings. After the trachea is (opened) uncovered a tracheostomy container of appropriate size is embedded.
Tracheostomy tube is helded in place by tapes fastened around the patients neck usually and a square of sterile gauze is placed between the tube and skin to absorb drainage and forestall disease.
Complications:
Early complications immediately after the trachestomy is performed include:
• dying
• pneumothorax
• air embolism
• aspiration
• subcutaneous or mediastinal emphysema
• intermittent laryngeal nerve damage or
• back tracheal wall penetration.
Long-term complications include:
- air way checks because of accumulation of secretions.
- infection
- dysphasia
- tracheo-esophageal fistula
- tracheal dilation
- tracheal ischemia and rot
- tracheal stenosis after removal of tracheostomy tube.
Immediate Postoperative Nursing care:
• The patient requires ceaseless checking and assessment.
• The opening must be kept patent by legitimate suctioning of emissions.
• After the vital signs are stable, the patient is placed in semi-fowler’s situation to facilitate ventilation, advance drainage, limit edema and forestall strain on the suture lines.
• Analgesic and sedative medications are administered with caution because it is undesirable to discourage the hack reflex.
• Paper and pencil, and the patient call light are kept inside reach of patient to guarantee a means of communication.
• Psychosocial care
Tracheostomy Tube and healthy skin:
• Inspect tracheostomy dressing for dampness or drainage
• Wash hands
• Wear clean gloves, evacuate dirtied dressing and discard.
• Prepare and arrange sterile supplies (cotton tipped applicators, dressing materials,hydrogen peroxide, normal saline, or sterile water).
• Put on sterile gloves.
• Cleanse wound and tracheostomy tube with sterile applicators dampened with hydrogen peroxide and flush with clean saline.
• If old tapes of external cannula are dirty change it with care and secure with a bunch.
• Remove old tapes and discard.
• Use sterile tracheostomy dressing and fit safely to spread the cut.
