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NHSGGC - Care of Tracheostomy: Inner Tube Change
Introduction
The care and maintenance of a tracheostomy are crucial to ensure patient safety and wellbeing. One key aspect of this care is the regular changing of the inner tube. The NHS Greater Glasgow and Clyde (NHSGGC) offers comprehensive guidelines to ensure proper procedures are followed to minimise risk and promote comfort for patients.
Importance of Changing the Inner Tube
Changing the inner tube of a tracheostomy is important to prevent blockages caused by mucus and other secretions. Regular changes reduce the risk of infection, improve breathing, and ensure the tracheostomy functions effectively. Within the UK, tracheostomy care is a priority for patient safety and is guided by established NHS protocols.
Preparation for Inner Tube Change
Before starting, ensure all necessary equipment is ready: a new inner tube, gloves, sterile water or saline, suction apparatus, and any specific equipment detailed by NHSGGC guidelines. Wash hands thoroughly and put on gloves to maintain hygiene.
Steps to Changing the Inner Tube
- Prepare the patient, ensuring they are comfortable and understand the procedure.
- Unlock and gently remove the existing inner tube while holding the outer tube securely in place.
- Inspect the removed tube for secretions or damage. Clean it properly if it's intended for reuse or dispose of it accordingly if it is for single use.
- Insert the new, clean inner tube gently, ensuring it clicks or secures into place.
- Check for proper placement and ensure the patient is comfortable and can breathe without difficulty.
Post-Procedure Care
After changing the inner tube, monitor the patient for any signs of distress or complications such as bleeding, unusual secretions, or difficulty breathing. Document the procedure in the patient's records, noting any observations or actions taken. Ensuring a clean and secure tracheostomy site at all times is paramount.
Conclusion
Following NHSGGC’s guidelines for tracheostomy inner tube changes helps ensure patient safety and effective care. By adhering to the recommended procedures and maintaining high standards of hygiene and monitoring, healthcare providers can significantly improve patient outcomes.
Frequently Asked Questions
What is an inner tube in a tracheostomy?
An inner tube is a removable, smaller tube that fits inside the main outer tube of a tracheostomy, ensuring the airway stays clear and prevents mucus buildup.
Why is it important to change the inner tube regularly?
Changing the inner tube regularly helps prevent infections, ensures the tube remains clear of mucus, and maintains the effectiveness of the tracheostomy.
How often should the inner tube be changed?
Inner tubes should typically be changed at least once daily, or more frequently if required, based on the patient's condition and medical advice.
What should I do before changing the inner tube?
Before changing the inner tube, ensure you wash your hands thoroughly, prepare the new inner tube and any other needed equipment, and ensure the patient is in a comfortable position.
Can I change the inner tube by myself?
Yes, with proper training and guidance from healthcare professionals, you can safely change the inner tube yourself. Always follow the specific instructions provided.
How do I remove the inner tube?
To remove the inner tube, carefully unlock the securing mechanism, usually by rotating or unlocking a connector, and gently pull it out while supporting the outer tube.
How do I insert a new inner tube?
Insert the new inner tube by gently guiding it into the outer tube, ensuring it is properly aligned and securely fastened according to the manufacturer's instructions.
What should I do if the new inner tube doesn't fit correctly?
If the new inner tube doesn't fit correctly, check for any blockages or misalignments. If problems persist, refer to the manufacturer's instructions or contact a healthcare professional.
What precautions should I take during the inner tube change?
Ensure a clean environment, wash hands thoroughly, avoid contamination, and follow the exact steps provided in the instruction manual or by healthcare providers.
How can I clean the inner tube?
If the inner tube is designed to be reusable, clean it with sterile water or saline, following specific cleaning instructions provided by the manufacturer or healthcare provider.
What are the signs of an infection related to the tracheostomy?
Signs of infection include redness, swelling, increased discharge, foul odour, fever, or pain around the tracheostomy site. Contact healthcare professionals if any of these symptoms occur.
What should I do if the patient has difficulty breathing after inner tube change?
If the patient has difficulty breathing, ensure the inner tube is properly fitted and clear of obstructions. If breathing issues persist, seek immediate medical assistance.
Can I use any type of inner tube with the tracheostomy?
No, you should use only the specific type and size of inner tube recommended by the healthcare provider or the tracheostomy tube manufacturer.
How do I know if the inner tube needs to be changed more frequently?
Signs that the inner tube needs more frequent changes include visible mucus buildup, difficulty breathing, and decreased effectiveness of the airway.
What support is available if I have concerns about changing the inner tube?
Support is available from healthcare providers, such as NHS services, specialized nurses, and instructional resources provided by manufacturers or healthcare institutions.
Useful Links
Useful links from: Tracheostomy
- NHS - Tracheostomy The NHS page provides comprehensive information on tracheostomy, including why it's needed, how it's performed, and the care involved.
- Tracheostomy Care - NHS UK This NHS page offers guidance on caring for a tracheostomy, with tips on cleaning, managing equipment, and recognizing potential complications.
- National Tracheostomy Safety Project The National Tracheostomy Safety Project provides resources and education about tracheostomy safety for patients, families, and healthcare providers.
- The Tracheostomy Review & Management Service (TRAMS) - St George's University Hospitals NHS Foundation Trust St George's TRAMS initiative supports the safe management and review of tracheostomy patients within the hospital setting.
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- Videos shown by Youtube after a video has completed, have NOT been reviewed by ERGSY.
- To view, click the arrow in centre of video.
- Most of the videos you find here will have subtitles and/or closed captions available.
- You may need to turn these on, and choose your preferred language.
- Go to the video you'd like to watch.
- If closed captions (CC) are available, settings will be visible on the bottom right of the video player.
- To turn on Captions, click settings .
- To turn off Captions, click settings again.