What do you do if patient pulls out tracheostomy?

If the tracheostomy tube falls out

  1. If the patient normally required oxygen and/or is on a ventilator, place oxygen over the tracheal stoma site.
  2. Gather the equipment needed for the tracheostomy tube change.
  3. Always have a clean tracheostomy tube and ties available at all times.
  4. Wash your hands if you have time.

How do you perform a tracheostomy Decannulation?

The patient is placed supine (flat) on their bed, the tube is removed and the opening into the neck is covered with sterile gauze and a tape is placed over the gauze. The patient is instructed to occlude the gauze with their finger tip every time they cough or speak so that air does not leak.

How do you prepare for Decannulation?

PROCEDURE

  1. Wash hands thoroughly and don gloves.
  2. Explain the procedure to the patient.
  3. Always deflate the cuff before the decannulation (see Tracheostomy tube cuff procedure).
  4. Assess the patient carefully for signs of respiratory difficulty and continue to observe at frequent intervals.

Can nurses reinsert tracheostomy?

2.2. 3.1 An RN or LPN may perform tube reinsertion in an emergency situation when an authorized practitioner is not available.

How can Decannulation be prevented?

To prevent accidental tracheal decannulation, make sure the tube is properly secured, minimize manipulation of the tube and traction on the tube from oxygen or ventilator tubing, and encourage the patient to move cautiously until the tract is healed.

When is Decannulation done?

Decannulation may be performed when the patient can tolerate plugging of the tracheostomy tube overnight while asleep without oxygen desaturation. After the tube is removed, the skin edges are taped shut, the patient is encouraged to occlude the defect while speaking or coughing. The wound should heal within 5-7 days.

What is the purpose of Decannulation?

Decannulation is an essential step towards liberating a tracheostomized patient from mechanical ventilation. This transition is more often individualized than protocolized. Universally accepted protocol is needed for better standardization.

When is it safe to Decannulate a tracheostomy?

In the Centers for Disease Control and Prevention’s Guidelines for Preventing Healthcare Associated Pneumonia (2004), the first recommendation is to remove the tracheostomy (or endotracheal tube) as soon as possible. The sooner patients are decannulated, the faster their risk for acquiring pneumonia decreases.