Tracheostomy Care
A tracheostomy tube is a medical device inserted into the trachea, the medical term for the windpipe, in order to establish an airway for breathing. The surgical procedure, called a tracheostomy, is typically performed in situations where there is a blockage or obstruction in the upper airway, which happens in situations like accident or trauma, in case of a cancer diagnosis, or when a patient requires long-term mechanical ventilation in a hospital setting, like in an ICU for example. A surgeon would create an opening in the neck, called a stoma, bypassing the nose and mouth, and then inserting the tube. This way, the tracheostomy tube allows air to flow directly into the trachea.
Tracheostomy tubes come in different sizes, shapes, and build materials, depending on the specific condition, needs and diagnosis of the patient and also the expected duration of its use. The device itself usually consists of a hollow tube with an inflatable cuff – or sometimes a balloon – that helps to secure the tube in place and prevents any possible air leakages. It may also have additional features such as an inner cannula for example, fenestrations (holes), or speaking valves to facilitate breathing, suctioning, or speech for patients who are unable to communicate orally.
Once the tracheostomy tube is in place, patients who have them require ongoing and continuous monitoring and care to prevent complications from happening. Things like infections, aspiration, tube displacement, or airway obstruction. Nursing care, suctioning of secretions that might accumulate and block the tube, and regular tube cleaning/changes are essential to ensure the comfort of patients with tracheostomy tubes.
JPR Home Health Care’s DHA-licensed nurses and caregivers are particularly trained on how to care for patients with tracheostomy tube in keeping with international care standards.
Who needs a tracheostomy tube?
A lot of individuals who have certain medical or surgical conditions maybe prescribed a tracheostomy tube by their treating doctor. For example, in conditions or situations that compromise their ability to breathe.
Below are some of the common reasons why someone might need a tracheostomy tube:
- Upper Airway Obstruction: In patients diagnosed with conditions such as tumors, trauma, infections, or congenital abnormalities in the structures comprising the upper airway, it can be difficult to breathe normally as these abnormalities can cause blockages that impede airflow. A tracheostomy tube in these patients can provide a way to bypass the obstruction, thereby allowing air to reach the lungs more easily.
- Long-Term Mechanical Ventilation: Patients who might need prolonged mechanical ventilation, typically for more than a few weeks, may be considered for a tracheostomy so as to facilitate breathing and reduce their risk of complications associated with more invasive procedures, like endotracheal intubation.
- Neuromuscular Disorders: These conditions lead to muscular weakness affecting various muscles in the human body, including the one responsible for respiration, namely the diaphragm. Individuals diagnosed with neuromuscular or neurological disorders, such as muscular dystrophy, amyotrophic lateral sclerosis (ALS), also known as Motor Neuron Disease, spinal cord injuries….etc, may experience muscle weakness, or even paralysis in severe cases, that in turn affects their ability to breathe. In these instances, A tracheostomy tube can provide stable and reliable airway access for mechanical ventilation or assistive breathing devices.
- Severe Respiratory Failure: Patients with severe respiratory failure, which could be caused by a myriad of diseases, like COPD for example, may require mechanical ventilation to provide support for their breathing until their condition improves.
- Airway Clearance: Some Individuals, like those affected by Cystic Fibrosis, tend to produce excessive respiratory secretions that might make breathing harder for them. These patients may benefit from a tracheostomy tube to facilitate suctioning and airway clearance.
- Facilitation of Weaning from Ventilation: Patients who’ve been mechanically ventilated for prolonged periods of time, like in an ICU setting for example, may find it difficult to go off this supportive device. In these cases, a tracheostomy tube may help in the weaning process by allowing for more comfortable and stable ventilation and enabling easier access for respiratory therapy interventions.
Overall, the decision to place a tracheostomy tube is based on careful consideration of the patient’s medical condition, his respiratory status and goals of care, all of which are decisions that should be made in consultation with the treating multi-disciplinary team responsible for the patient. This team is often made up of multiple healthcare professionals from various specialties, including physicians, respiratory therapists, critical care specialists, home care providers, in collaboration with the patient and their family.
What are problems faced by tracheostomy patients?
Tracheostomy, while often a life-saving procedure, can sometimes, in certain patients, also present various complications and extra distress to the patients and their families who might already be on edge. These complication can sometimes be short-lived, but they can also persist for prolonged periods of time. The following are some of the common ones:Here are some of the common ones:
- Infection: Typically cause by bacteria that live on the human skin. They usually occur at the tracheostomy site, but sometimes they might also affect the respiratory trac. Bacteria can enter the trachea through the opening of the tube, which might later on lead to infections such as cellulitis, tracheitis, or even pneumonia- infection of the lung tissue. That’s why Proper hygiene and care are crucial to prevent infections -something our private home care nurses in Dubai, Sharjah, Ajman, Abu Dhabi, Ras Al Khaimah, Umm al quwain and Al ain are specially trained to do.
- Tracheal Stenosis: Patients who’ve a tracheostomy tube in for long periods of time might experience narrowing of the trachea, known as tracheal stenosis. This can lead to difficulty breathing difficulties and may require further hospital-based surgical interventions.
- Granuloma Formation: Granulomas are small, benign growths that can develop in areas of chronic inflammation, like the tracheostomy wound for example, which if the get too large might interfere with normal breathing.
- Tracheoesophageal Fistula: In rare cases, a communication can form between the trachea and the esophagus, known as a tracheoesophageal fistula. This can lead to food or drinks getting into the lungs, increasing the risk of serious complications.
- Tube Dislodgment: Accidental displacement of the tracheostomy tube can sometimes occur, due to an error on the family or the patient’s side, that’s why having trained DHA-licensed home care nurses in Dubai, like the ones provided by JPR Home Health Care, can mean the difference between life and death. Dislodgement of the tube can lead to airway obstruction and respiratory distress. Proper securing of the tube in place and close monitoring of the patient are essential to prevent this from happening.
- Bleeding: Bleeding from the tracheostomy site or within the trachea can occur, especially during tube changes or suctioning. While minor bleeding is common and shouldn’t be something to worry about, if significant bleeding is observed, the patient supervising needs to be informed right aways and arrangements made for a hospital transfer.
- Voice Changes: Tracheostomy can affect the patient’s speech and voice quality, particularly if the vocal cords are bypassed by the tube. Speech therapy may be needed to help patients adapt to changes in speaking and communication.
- Mucous Plugging: Excessive mucoid secretions from the upper respiratory tract can make their way to the tracheostomy tube and lead to blockages and difficulty breathing. Regular suctioning of the tube and steam humidification to dissolve the secretions can help prevent mucous plugs from forming. Our private home nurses in Dubai, Sharjah, Ajman, Abu Dhabi, Ras al khaimah and Al ain, are particularly trained on how to care for these types of patients.
- Skin Irritation: Friction from the tube or the adhesive used to fix it in place, can cause the skin around the tracheostomy site to become irritated or infected. Keeping the skin around the tube dry and moisturized can make a huge difference in preventing this sequelae.
- Psychological Impact: A tracheostomy tube can have a significant psychological impact on patients, leading to them feelings anxious or even depressed at times. Support from trained home care professionals, family members, and support groups can help patients cope with these emotional challenges.
It’s important for healthcare providers and caregivers to be aware of these potential complications and take proactive measures to prevent and manage them effectively. Our DHA-licensed nurses and trained caregivers provide regular monitoring, proper tracheostomy care, and prompt medical intervention, minimizing the risk of complications and ensuring the safety and well-being of patients with tracheostomy.
How to care for tracheostomy at home?
Caring for a tracheostomy tube is one of the essential component of home care for such patients, with the aim of minimizing or preventing the occurence of complications.
Here are some useful – and important- steps to follow for tracheostomy tube care at home:
- Clean hands: Before handling the tracheostomy tube, or performing procedures or manipulation, make sure you wash your hands thoroughly with soap and water, and in the absence of which use a hand sanitizer instead.
- Daily Cleaning: Cleaning around the tracheostomy site daily using mild soap and water or a saline solution is really important in order to keep the site clean and decrease the likelihood of an infection developing. You should try to gently remove any crusting or secretions that might be stuck on the skin around the stoma and the inner cannula of the tracheostomy tube using a sterile gauze or cotton-tipped applicator.
- Periodic Dressings: In many instances, there can be a dressing around the tracheostomy opening to anchor the tube in place and prevent direct contact with the skin to minimize friction. If dressings are used, they ought to be changed regularly according to the supervising physician’s recommendations.
- Suctioning: Regularly suction the tracheostomy tube to remove excess mucus and secretions that might get trapped within it. You can a clean suction catheter of the appropriate size and follow the patient physician’s instructions for which suctioning technique to use, how frequently and for how long.
- Inner Cannula Care: Some tracheostomy tubes have a removable inner cannula. This part should also be cleaned with saline and a sterile cotton pad on a regular basis. Sometimes, it might need to be replaced altogether.
- Humidification: Insertion of a tracheostomy tube interferes with the normal mechanisms of the upper airway lubrication. Ensure that the patient receives adequate humidification to maintain moisture in the airway. To achieve this, you can use a humidifier attached to the tracheostomy tube, or you can also use a nebulizer.
- Securing the Tube: To prevent accidental dislodgment or displacement, leading to respiratory compromise or even death, make sure that the tracheostomy tube is securely positioned on the neck. But make sure that whatever you use for fixing the tube is neither too tight nor too loose.
- Monitoring for Signs of Danger: Keep a close eye on the patient in general, and also the tracheostomy site for any signs of infection, irritation, or skin breakdown. Also, make certain that you continuously monitor the patient’s respiratory status, oxygen saturation levels using a pulse oximeter, and breathing pattern to detect any problems early on.
- Communication: If the patient has difficulty speaking due to the presence of the tracheostomy tube, alternative means of communication such be provided such as writing, or using an assistive communication devices, which can be a bit more costly.
- Education and Training: family members should receive comprehensive education and training on tracheostomy tube care and what needs to be done in cases of an emergency. They should be familiarized with the equipment, know how to troubleshoot common problems, and understand when to seek help from the doctor or if an ambulance is needed.
It’s essential to follow the treating physicians’s instructions and the manufacturer’s recommendations for tracheostomy tube care to ensure optimal patient care. If you have any questions or concerns about caring for a tracheostomy tube or find the process a little bit too difficult to handle on your own, don’t hesitate to reach out to JPR Home Health Care and we’ll send a licensed nurse or caregiver directly to your home anywhere in the UAE, whether Dubai, Sharjah, Abu Dhabi, Al ain, Ajman or Ras al Khaimah or Fujairah, our team of clinical service providers are there to help with all your home health care needs.
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Our tracheostomy home care services
in Dubai & UAE include:
Monitoring & care
our nurses will look for any signs of blockage or dysfunction with the tube.
Regular suctioning
Our clinical team will perform periodic mucous discarding to maintain tube patency.
Dressing change
Our DHA-licensed nurses remove old dressing and replace them acccoring to a set schedule.
Neck skin care
Our team will make sure the skin surrounding the tube remains clean and moisturised.
Air humification
Our nurses make sure the air inhaled by the patient isn’t dry so patient remains comfortable.
Reassurance & education
Our nurses are specially trained to care for patients with tracheostomy.
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Frequently asked questions
How can I reach out to you?
We’re available 24/7 through the phone or WhatsApp at 0508738150 or through our Contact Us page.
My father is being discharged with a tracheostomy tube can your nurses help?
At JPR Home Health Care, we pride ourselves on offering a wide variety of home care services designed to meet the diverse needs of families and people of all ages including those with tracheostomy tubes. We have a team of DHA-licensed nurses who have been trained to specifically take care of patients with this crucial breathing device.
Our team of dedicated caregivers and licensed nurses is committed to delivering high-quality, compassionate care tailored to your loved ones’ unique needs, ensuring that they receive the nurturing and support they deserve in the comfort of their own home. Whether you need occasional assistance or ongoing support, you can trust us to provide the care and guidance your family needs to thrive.
Are your nurses and caregivers experienced in tracheostomy care?
Our home care nurses hold at least a bachelors degree in addition to at least one year of experience caring for patients within the UAE and overseas. They have also been trained to care specifically for patients on long term care as is the case for those with tracheostomy tubes and other assiested-breating equipments.
As part of our commitment to providing the best home health care in UAE, ALL of our home nurses are certified by the DHA, DOH or MOH.
Is the tracheostomy care service available in Abu Dhabi?
Yes.
JPR Home Health Care remains committed to providing the best home health care to all resident of the UAE whether in Abu Dhabi, Dubai, Sharjah, Al ain, Ras al khaimah, Ajman or Fujirah. Call us today on 050-873-8150 and get a free consultation.
How much do you charge per month?
We offer the most competitive rates in the industry, and our rates start from as low as AED 20 per hour. Call us today at 0508738150 to get a free consultation with one of our team members.
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