HNN329 - Tracheostomy Dressing_default

Introduction to Tracheostomy Dressing Change

• The procedure requires two people for safety and efficiency.

Initial Setup

• Assess the current dressing to determine if it needs changing (appearance: goopy).

• Ensure the patient's comfort by repositioning and removing oxygen if tolerated.

  • Alastair can manage without oxygen during the procedure.

• Adjust the gown to access the tracheostomy easily.

• Sit up the patient for comfort and support, head tilt back to see the trache more easy

• Use a Bluie (absorbent pad) to catch any drips during the process.

Preparation Phase

• Call assistance to help with the procedure.

• Prepare sterile gloves for both caregivers.

• Set up the sterile field for the dressing change.

Materials Needed

• Special tracheostomy gauze (preferred over regular gauze to avoid contamination).

• Disposable bin bag for hygienic disposal of used materials.

• 0.9% sodium chloride for cleaning the site (less irritating than alcohol).

• Additional spare gauze for drying or stabilizing if needed.

Performing the Dressing Change

• Pre-cleaning: Wipe down the sterile field and allow it to dry.

• Prepare gauze and cleaning solution for use.

• Reusing Ties: Assess the cleanliness of tracheostomy ties before reusing; replace if excessively soiled.

• Use clean gloves to remove the old dressing and ties.

• Assistants' Role: Hold the tracheostomy tube securely during dressing change to maintain airway patency.

Dressing Removal

• Undo ties while the tube is held secure.

• Option to leave ties on for a quick change or remove entirely for washing.

• Dispose of the old dressing using appropriate infection control measures.

• Perform hand hygiene before putting on sterile gloves.

Cleaning the Site

• Don’t put too much pressure on the tracheostomy site while cleaning to avoid discomfort or damage to the surrounding tissue.

• Monitor patient status, including respiratory rate and comfort level, during the process.

• Could do vital sign the procedure to assess any changes in the patient's condition and ensure they are stable throughout and after the cleaning process.

• Use a mix of clean and soiled hands (clean hand for sterile field, soiled hand for cleaning) to clean around the tracheostomy site thoroughly to avoid introducing contaminants.

• Ensure the gauze used to clean and dress is adequately drained to avoid liquid entering the wound by making sure the dressing aren’t too wet.

Applying New Dressing

• Apply the new dressing by folding sides down smoothly to prevent pressure injuries.

• Reapply ties: ensure proper technique with a loop system.

• Ensure ties are both secure (not too tight) and correctly positioned around the patient's neck.

• Monitor the patient's comfort while tying to avoid discomfort.

Final Steps

• Confirm that the dressing is smooth and secured properly.

• Return the patient to a comfortable position.

• Dispose of waste responsibly and clean up the area.