PROCEDURE: ASSISTING AT A TRACHEOSTOMY

INDICATIONS:

1. SUDDEN BLOCKAGE IN THE MOUTH OR THROAT

2. THROAT SURGERY CLIENTS

3. LONG TERM MECHANICAL VENTILATION CLIENTS

SUPPLIES AND EQUIPMENT NEEDED:

1. Sterile, disposable tracheostomy tray

2. Local anesthetic, such as procaine hydrochloride (Novocain) or

3. lidocaine (Xylocaine)

4. Syringes and small-gauge needles

5. Sterile and clean gloves for physician and nurse

6. Strong light

7. Emergency breathing apparatus (such as manual breathing bag)

8. Source of oxygen

9. Source of suction

ASSESS:

1. VITAL SIGNS

2. RESPIRATORY STATUS

3. ANY BLOCKAGE IN THE AIRWAY

1. STANDARD STEPS:
a. CHECK ORDER
b. WASH HANDS
c. GET SUPPLIES
d. WASH HANDS
e. CHECK ARMBAND
f. ASSESS PT IN GENERAL
g. EXPLAIN PROCEDURE
h. BED UP, SIDE RAILS DOWN
i. PROPER POSITION
j. COMFORT OF PT (BODY SUPPORTED, RELAXED)
k. ASSESS WHAT PROTECTIVE EQUIPMENT
l. DO THE PRCEDURE:
FOLLOW LPN WELCOME STEPS AND THEN:

Follow LPN WELCOME steps and then:

1. Hold the client’s head during the procedure, if requested

by the physician. If necessary, place a folded towel behind

the client’s neck to hyperextend it and to expose the surgical

site.

.2. Provide strong emotional support.

3. Provide oxygen through an endotracheal tube while the

tracheostomy is being done. This is most often done using

a manual-breathing bag.

FOLLOW ENDD STEPS;

m. ASSESS PT IN GENERAL, BODY PART IN PARTICULAR

n. COMFORT OF PT
o. SAFETY OF PT
p. ROOM ORDER
q. WASH HANDS
r. CHART ON FLOWSHEET
1. ANY SIGNS OF RESPIRATORY DISTRESS
2. PAIN

s. LEAVE ROOM
t. REPORT PRN