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GENERAL OBJECTIVE:-
At the end of the demonstration acquire knowledge about the tracheostomy care and management of the various problems,
and care of the patient in home.

SPECIFIC OBJECTIVE:-at the end of the health education patients relative will be able to:-
 define tracheostomy care.
 discuss about various purposes of tracheostomy care.
 list down various article and equipment used in tracheostomy care.
 explain procedure step by step of tracheostomy care.
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TRACHEOSTOMY CARE
INTRODUCTION:- It is important to keep the stoma and the tracheostomy tube clean. To do this tracheostomy care should be
done at least twice a day and as needed. This includes cleaning the inner cannula, around the tracheostomy tube and the stoma.
Cleaning the tracheostomy tube is done by using clean technique. The tracheostomy tube should be changed once a month. This is
always done using a sterile technique.

Good hand washing technique is vital to prevent infections. You must always use gloves when dealing with tracheostomy tubes.

S. TIME SPECIFIC CONTENT TEACHING LEARNING A.V. EVALUATION

NO OBJECTIVE ACTIVITY ACTIVITY aids
.
1. 2min Define DEFINITION:- Explanation listening What do you
tracheostomy Tracheostomy care includes changing a tracheostomy inner mean by
care. tube, cleaning tracheostomy site and changing dressing tracheostomy
around the site. care?

2. 5min Discuss PURPOSES:- Explanation listening What are the

about 1. To maintain airway patency. purposes of
various 2. To prevent infection at the tracheostomy site. tracheostomy
purposes of 3. To facilitate healing and prevent skin excoriation care?
tracheostomy around the tracheostomy site.
care. 4. To promote comfort.
5. To assess condition of ostomy.

3. 5min List down EQUIPMENT:- Explanation listening Which type of

various 1. Tracheostomy care kit containing:- equipments are
article and a) Gallipots (3). using during
equipment b) Sterile towel. tracheostomy
used in c) Sterile nylon brush/tube brush. care?
tracheostomy d) Sterile gauze squares.
care. e) Cotton twill ties or tracheostomy tie tapes.
f) Sterile bowl for solution.
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2. A clean tray containing:-

a) Sterile suction catheter.
b) Hydrogen peroxide
c) Normal saline.
d) Sterile glovs-2 pairs.
e) Clean scissor.
f) Face mask and eye shield(optional).
g) K basin.
h) Waterproof pad.
3. Suction apparatus.

PROCEDURE CONTENT
S. TIME SPECIFIC ACTION RATIONALE TEACHING LEARNIN A.V. EVALUATI
NO OBJECTIVE ACTIVITY G aids ON
. ACTIVITY
1 1min Explain Assess condition of stoma: Presence of any of Explanation listening Roller How to
procedure (redness, swelling, character of these indicates board perform
step by step secretions, and presence of infection and culture tracheostomy
of purulence or bleeding. test may be warranted. care?
tracheostomy
care.

2 1min Examine neck for subcutaneous Indicates air leak into Explanation, Listening
emphysema evidenced by subcutaneous tissue. demonstration
crepitus around the ostomy site.
3 1min Explain procedure to the patient
and teach means of
communication such as eye
blinking or raising a finger to
indicate pain or distress.
4 1min Assist patient to a fowler’s Promotes lung Explanation, Listening
position and place waterproof expansion. Prevents demonstration
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pad on chest. soiling of linen.

5 3min Wash hand thoroughly. Prevents cross Explanation, Listening
infection. demonstration
6 2min Assemble equipments. Explanation, Listening Roller
 Open the sterile Hydrogen peroxide demonstration board
tracheostomy kit, pour and saline removes
hydrogen peroxide and mucus and crust which
sterile normal saline in promote bacterial
separate gallipots. growth.
 Open other sterile Enhance performance
supplies as needed phase of procedure.
including sterile
applications, suction kit
and tracheostomy care kit
(dressing kit). Protects the nurse.
 Put on face mask and eye
shield.
7 1min Don sterile gloves. Place sterile Maintains aseptic Explanation, Listening
towel on patient’s chest. technique. demonstration
8 30sec Suction the full length of Removes secretions. Explanation, Listening
tracheostomy tube and pharynx demonstration
thoroughly.
9 10sec Rinse the suction catheter and Explanation, Listening
discard it. demonstration
10 10sec Unlock the inner cannula (if Hydrogen peroxide Explanation, Listening Roller
present) and remove it by gently moistens and loosens demonstration board
pulling it out towards you in line dried secretions.
with its curvature.
Place the inner cannula in the
bowl with hydrogen peroxide
solution (application for tubes
having inner and cannula).
11 1min Remove the soiled tracheostomy Explanation, Listening
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dressing, discard the dressing and demonstration

gloves.
12 30sec Don a second pair of sterile Explanation, Listening
gloves. demonstration
13 2min Clean the flange of the tube using Using the applicator or Explanation, Listening Roller
sterile applicators or gauze gauze once only, demonstration board
moistened with hydrogen avoids contaminating a
peroxide and then with normal clean area with a soiled
saline. Use each applicator once gauze.
only.
14 1min Clean the stoma area with gauze Explanation, Listening
(make only a single sweep with demonstration
each gauze sponge before
discarding). Hydrogen peroxide
 Half strength hydrogen helps to loosen dry
peroxide (mixed with crusted secretions.
normal saline) may be
used. Hydrogen peroxide is
 Thoroughly cleanse area irritating to the skin
using gauze squares and inhibits healing if
moistened with sterile not removed
normal saline. thoroughly.
15 1min Dry the stoma with dry sterile Explanation, Listening
gauze. demonstration
An infected wound may be
cleaned with gauze saturated with
an antiseptic solution, then dried. Helps prevent wound
A thin layer of antibiotic infection.
ointment may be applied to the
stoma with a cotton swab.
16 2min Cleaning the inner cannula Explanation, Listening
 Remove the inner cannula demonstration
from the soaking solution.
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 Clean the lumen and

entire cannula thoroughly
using the brush. Through rinsing is
 Rinse the cleaned cannula important to remove
by rinsing it with sterile hydrogen peroxide
normal saline (agitating from inner cannula.
the cannula in the
container with saline
cleans it well). Removes solution
 Gently tap the cannula adhering on the
against the inside of the cannula.
sterile saline container
after rinsing.
17 1min Replace the inner cannula and Explanation, Listening
secure it in place: demonstration
 Insert the inner cannula
by grasping the outer
flange and pushing in the
direction of its curvature. This secures the flange
 Lock the cannula in place of the inner cannula to
by turning the lock (if the outer cannula.
present) into position.
18 1min Apply sterile dressing: Explanation, Listening
 Open and refold a 4*4 Avoid using cotton- demonstration
gauze dressing into a ‘V’ filled 4*4 gauze.
shape and place under the Cotton or gauze fiber
flange of the can be aspirated by the
tracheostomy tube. patient potentially
 Do not cut gauze piece. creating a tracheal
 Ensure that the abscess.
tracheostomy tube is
securely securely Excessive movement
supported while applying of the tracheostomy
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dressing. tube irritates the

trachea.
19 2min Change the tracheostomy ties Explanation, Listening
 Leave the soiled tape in Leaving tape in place demonstration
place until the new one is ensures that tube will
applied. not be expelled if
patient coughs or
 Cut a piece of tape that is moves.
twice the neck This action provides a
circumference plus 10 secure attachment with
cm. cut the ends of tape knot.
diagonally.
 Apply the new tape. Diagonal cut facilitates
 Remove old tapes insertion of tape into
carefully. openings of neck plate.
 Grasp slit end of
clean tape and pull
it through opening
on one side of the
tracheostomy
tube.
 Pull the other end
of the tape
securely through Prevents irritation and
the slit end of the aids in rotation of
tracheostomy tube pressure site.
on the other side.
 Tie the tapes at the
side of the neck in
a square knot. Excessive tightness
 Alternate knot compresses jugular
from side to side veins, decrease blood
each time tapes circulation to the skin
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are changed. and result in

 Ties should be discomfort for patient.
tight enough to
keep tube securely
in the stoma, and
loose enough to
permit two fingers
to fit between the
tape and neck.
20. 2min Document all relevant Explanation, Listening
information in the chart: demonstration
 Suctioning done.
 Tracheostomy care
carried out.
 Dressing change.
 Observations.

21. 1min SPECIAL CONSIDERATIONS:- Explanation Listening

1. Tracheostomy dressing should be done every 8
hours or whenever dressings are soiled.
2. Tracheostomy tubes may come with disposable
inner cannula or without the inner cannula. If
disposable inner cannula is present then replace the
one that is inside with a new one.
3. If only single lumen is present, then suction the
tracheostomy tube and clean the neck plate and
tracheostomy site

22. 2min CARE OF ARTICLE:- Explanation, Listening

• Clean the machine, container, bowl, and tubing demonstration
every day.
• Empty and rinse the suction container with cool
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water.
• Wash the suction container with water containing
clear, moisturizer free dish detergent.
• Rinse with hot water and dry with a clean cloth.
• Additional cleaning may be necessary. Your
equipment will have a filter which may require
cleaning. The equipment supplier may suggest you
use a vinegar mixture to clean the filter. Follow the
manufacturer’s instructions.

SUMMARY:- It is important to keep the stoma and the tracheostomy tube clean. To do this tracheostomy care should be done at least
twice a day and as needed. This includes cleaning the inner cannula, around the tracheostomy tube and the stoma. Cleaning the
tracheostomy tube is done by using clean technique. Tracheostomy care includes changing a tracheostomy inner tube, cleaning
tracheostomy site and changing dressing around the site.
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BIBLIOGRAPHY

1. POTTER & PERRY’S Text book of ‘‘FUNDAMENTAL OF NURSING”

South Asian Edition. PUBLISHED BY: - Elsevier publication. PAGE NO:-829.

2. WILKINSON M. JUDITH “FUNDAMENTAL OF NURSING’’

EDITION:- 2ND Edition . PUBLISHED BY: - F.A. Davis. PAGE NO:- 889-890.

3. LIPPINCOTT’S ‘‘NURSING PROCEDURES”

EDITION:- 5TH Edition . PUBLISHED BY:- Wolter kluwer. PAGE NO:- 552-559.

4. JACOB ANNAMMA ‘‘CLINICAL NURSING PROCEDURES’’

EDITION: - 3RD Edition. PUBLISHED BY:- Jaypee brothers. PAGE NO.-400-404.

INTERNET

1. WWW.TRECHEOSTOMYCARE.COM
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GRACIOUS COLLEGE OF NURSING ABHANPUR RAIPUR (C.G.)

SUBJECT:- MEDICAL- SURGICAL NURSING- I

TOPIC:- DEMONSTRATION
ON
TRACHEOSTOMY CARE

SUBMITTED TO; SUBMITTED BY;

MS. OSIN CHANDRAKAR MAM MR.TOPESHWAR KANWAR

DEMONSTRATOR,MEDICAL SURGICAL NURSING M.SC.NURSING 1ST YEAR

GRACIOUS COLLEGE OF NURSING ABHANPUR GRACIOUSE COLLEGE OF

RAIPUR (C.G.) NURSING ABHANPUR (C.G.)

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DEMONSTRATION
NAME OF THE DEMONSTRATOR : - Mr. Topeshwar kanwar.

COURSE & YEAR : - M.Sc. Nursing 1st year

NAME OF THE SUPERVISOR : - Ms. Osin chandrakar .

SUBJECT : - Medical surgical nursing

TOPIC :-Tracheostomy care

NO. OF GROUP : - 5 students

DATE : - 22/01/2021

TIME : - 11:30am

VENUE : - MICU 1st floor

METHOD OF TEACHING : - Explanation, discussion, demonstration, lecture etc.

MEDIA OF TEACHING/ A.V. aids : - Roller board, hand out etc.

PREVIOUS KNOWLEDGE LEVEL : - Student have less knowledge about care of tracheostomy and how to manage the
airway through tracheostomy tube.