In-Home Tracheostomy Cannula Replacement

In-home tracheostomy cannula replacement and care is performed by an intensive care physician and an anesthesiologist or an otolaryngologist.

In-home tracheostomy cannula replacement is the procedure of opening a hole in the trachea on the neck under local or general anesthesia using a surgical method and thus providing respiratory tract clearance, in cases of respiratory distress due to various acute and chronic diseases or pathological reasons, for the purpose of supporting breathing and providing respiratory tract clearance. Tracheostomy cannula replacement, however, is the procedure of replacing the external apparatus that provides respiratory tract clearance by a specialist physician.

Tracheostomy can be temporary or permanent depending on the person’s condition.

Tracheostomy Cannula Replacement

Tracheostomy cannula replacement and care is performed by an intensive care physician and an anesthesiologist or an otolaryngologist.

In-Home Tracheostomy Cannula Replacement Procedure

Tracheostomy is performed by an intensive care specialist/anesthesiologist at the hospital by means of a surgical procedure when it is first done. Performing a tracheostomy for the first time is not done at home.

Once the patient’s tracheostomy is performed and the patient is discharged from hospital, the part that enters the throat, called the tracheostomy cannula, must be replaced regularly under sterile conditions with the support of an intensive care specialist/anesthesiologist and a nurse that will be assigned by home health and care services. Daily care of the tracheostomy cannula must be performed by the patient’s relatives at certain periods with appropriate disinfection methods.

In Which Diseases or Conditions Is Tracheostomy Procedure Considered?

In the following cases, a tracheostomy procedure can be performed.

  • Blockage of the respiratory tract for any reason,
  • Breathing difficulties caused by edema (swelling), injury or various lung conditions in the respiratory tract.
  • Respiratory problems caused by the decrease or loss of the respiratory muscle functions,
  • In order to prevent food and oral fluids from entering the respiratory tract in patients who cannot chew and swallow on their own due to Alzheimer’s, old age or another disease,
  • In cases such as cerebral hemorrhage or severe head trauma,
  • Tracheostomy is performed in patients who cannot breathe on their own for 10 days or more due to some diseases, and in patients who need long-term breathing apparatus support.
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    Training of the Relatives of Patients with Tracheostomy

    Hygiene is very important in the care of the patient with a tracheostomy. It is necessary to check the open area in the throat and to protect that area against infection. For this reason, physicians and nurses provide detailed information to the relatives of patients regarding the matters such as “daily care of tracheostomy, tube exchange periods, recommendations against infections, indicators of infection, respiratory problems, and control of sputum discharge, bleeding, nutrition”. The relatives of patients must definitely call their physicians in case of a possible problem during this process carried out at home.

    All infections must be taken into consideration.

    The tracheostomy location is an open area. It is very important to protect this area against infections, therefore keep it clean and dressed. The most critical issues in the tracheostomy area are the presence of rash, local temperature increase, nasty smell and discharge. When these situations are encountered, the physician must be informed and, if necessary, medical assistance must be received. It is of critical importance to ensure that the materials used in dressings are sterile.

    Tracheostomy care materials and things to do

    Tracheostomy care is done daily by the relatives of the patients. The materials required for care should be available.

    Tracheostomy Care Materials

    • Glove,
    • Sterile gauze bandage,
    • Tracheostomy pillow,
    • Tracheostomy tie,
    • Iodine,
    • Physiological saline solution

    Tracheostomy Care Procedure

    • The hands of the caregiver are washed and gloves are worn.
    • The tracheostomy pillow is removed and the surrounding area is cleaned with physiological saline solution,
    • Cannula incision is observed for rash or inflammation,
    • If signs of infection are observed, sterile gauze bandage and iodine are applied in circular motions from the inside out.
    • During the cleaning process, necessary care must be taken for the cannula not to move.
    • Sterile tracheostomy pad is placed around the cannula,
    • In order to support the neck piece and prevent the cannula from coming off, the tracheostomy tie is fixed by passing through the holes on the sides of the cannula.
    • The patient may have the need to gag or cough due to movement during cleaning. Keep your calmness and allow such action. You should hold the cannula steady for a while in your hand and wait for the coughing to end.
    • Tracheostomy outer balloon and its inflation must be checked every 1-2 hours.
    • Sputum (secretion) must be cleared.
    • If the patient has a speech problem, he/she must be informed he/she will recover with a psychological approach.

    What is a Tracheostomy Cannula?

    Tracheostomy cannula is a small cannula that is placed in that area to maintain this opening after the tracheostomy is done.

    Tracheostomy cannulas come in various sizes and materials such as semi-flexible plastic, rigid plastic or metal. Cannulas can be disposable or can be used repeatedly. These cannulas may also include an inner cannula. Tube selection depends on the condition of the patients, neck shape, size and purpose of the tracheostomy.

    All tracheostomies have an outer cannula and a neck plate. The neck plate rests against the tracheostomy incision in the patient’s neck. The holes on either side of the neck plate are used to secure the tracheostomy tube in place.

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