How Tracheostomy Care Is Essential For Patients

Mrs. Helen Bessler, mother of George Bessler, was hospitalized 16March2015 and underwent surgery of the right lung on 17March2015. She had cancer of the right lung that required removal of two lobes and a section of the superior vena cava.

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

L.M. is a 75-year-old female who suffers from severe dementia and lives in a SNF. She was diagnosed with lung cancer in 2005 and as a result had a right upper and middle lobectomy. She also has a history of severe emphysema. L.M. has had several pneumonic infections and has an allergy to Pneumovax. She has a recurrent aspiration risk and received a tracheostomy and a PEG tube in January 2012.

INDICATIONS FOR SURGERY: The patient is a 62-year-old Caucasian male who has pneumonia. The patient has been on a ventilator for over 2 weeks and appears to require long-term ventilator. The patient is undergoing tracheostomy for this purpose.

When the organs fail the only option is a transplant. With lungs there is only a 50% rate of a five year survival rate after a lung transplantation involving the end-stage respiratory disease. With such a drastic survival rate a study was completed to determine if patients could have a better outcome. This study was done to help determine effective methods to enhance lung transplants before surgery; the Doctors placed the recipients on bi-level positive airway pressure ventilation (BIPAP.) “BIPAP is a noninvasive mode of ventilation administered through a tight-fitting mask to assist spontaneously breathing patients”

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

One of the most important things to maintain a trauma patients airway is ensuring that you have adequate help around (Stephens, 2011). This is important because there are many different tasks that must be delegated in maintaining this persons airway. Some of these processes include opening the airway, suctioning the airway, inserting the proper adjunct, and maintaining

The aim of this paper is to critique the research article, “Accidental Decannulation Following Placement of a Tracheostomy Tube” published in Respir Care (White, Purcell, Urquhart, Joseph, and O’Connor, 2012). The article wants to find out the causes of increased rate of mortality and morbidity due to accidental decannulation following tracheostomy place in long-term acute care hospitals (LTACH). This paper seeks to evaluate the strengths and weaknesses of this research process to establish its efficiency and practicality.

In recent years respiratory therapy has gained a vast amount of recognition. According to "The Bureau of Labor Statistics", the employment of respiratory therapists is projected to grow nineteen percent over the next seven years. Along with increasing advancements in technology and medical research, there is also an ever increasing demand for respiratory therapists worldwide. Breathing is something that every individual must do, however, there are sometimes altercations in doing so, and this is where respiratory therapy comes into effect. In order to learn more about this topic, I enrolled into a Writing and Research course at my college. Upon taking this course, I had the pleasure of shadowing a couple of respiratory therapists at

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).

The hole is made to help the patient breathe. A tracheostomy usually is temporary, although patient can have it long term or even permanently. Patients with a tracheostomy are considered to be high risk and have numerous complexities for nurses to consider because of respiratory problems. In addition to understanding facility policy regarding tracheostomy care, nurses must possess the specific knowledge and skills to provide successful care. Evidence-based research has provided the foundation for nurses to improve nursing care standards and practice regarding tracheostomy care (Schreiber, 2015). The faculty must be qualified and knowledgeable about simulation lab (SIM lab) in conjunction with tracheostomy care as teaching-learning strategies in order to be successfully teach their students within their work environment. The SIM lab is an important learning tool because it is team based faculty learning that consistently improves academic outcomes by shifting the instructional focus from knowledge transmission to knowledge application. The Capstone project is devised to plan and develop faculty skills in teaching with technology that incorporated the use of SIM lab. The purpose of faculty training is to examine evidence based practice in simulation of care and nursing

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

Nose and mouth warm and moisten the air that travels through them. It also helps with clearing out mucus secretion. Exclusion of the nose and mouth means a buildup of secretion in the oxygen cap. So, it is crucial to suction out secretions and clear the inner cannula carefully for any blockage or build up. Nurses have a huge responsibility when it comes to tracheostomy. They have to keep it clean, clear out secretions and care for surrounding tissue. They also have to consider about providing the individual with some way of

Tracheostomys may be required for long term control of excessive bronchial secretions, particularly in those with reduced consciousness or to maintain an