Overview
Why Routine Maintenance Prevents Airway Failure
A 58 year old man is on a surgical ward on day 3 after a tracheostomy, breathing spontaneously through a cuffed tube with humidified oxygen.
NCLEX-RN
NCLEX-RN
A 58-year-old man is on a surgical ward on day 3 after a tracheostomy, breathing spontaneously through a cuffed tube with humidified oxygen. At 02:00 he is restless and his breathing is noisy. His respiratory rate has risen from 18 to 28 breaths/min, his heart rate from 84 to 118 beats/min, and his oxygen saturation has fallen from 96% to 87%. By the end of this lesson you will be able to decide what to do in the first minute, and why a dressing change or a saline instillation is not part of it. Clinical priority: treat new distress in a person with a tracheostomy as a blocked or displaced tube until proven otherwise, because the tube is the only reliable route for air. After this lesson the RN will be able to: - explain why a tracheostomy needs humidification and why a blocked tube can cause respiratory arrest; - perform a baseline airway assessment and identify the airway type before any care; - choose a suction catheter no larger than half the tube's inner diameter and suction only when...
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