Assessment

Before intervening in the care of a tracheostomy, a full patient assessment should be undertaken. What should this include?

Answer

Before intervening in the care of a tracheostomy, a full patient assessment should be undertaken. What should this include?

Information you need includes:

  • Does the patient have a tracheostomy or a laryngectomy?
  • Why does the patient have a tracheostomy?
  • When was the tracheostomy performed?
  • Was it surgical or percutaneous (may have implications for ease of re-insertion)?
  • The type and size of tracheostomy tube & availability of spare & emergency equipment
  • Is there an inner tube and, if so, does it need cleaning?
  • Is the tube secured (sutures or ties)?
  • Check the cough effort and sputum load
  • Check the patient's ability to swallow, including any SALT assessments
  • Check that the stoma dressing is clean

Remember, any sign of deterioration can be due to a tracheostomy or airway problem. Remember 'Red Flags'.

Where can you find this information?

Answer

Before intervening in the care of a tracheostomy, a full patient assessment should be undertaken. What should this include?

Information you need includes:

  • Does the patient have a tracheostomy or a laryngectomy?
  • Why does the patient have a tracheostomy?
  • When was the tracheostomy performed?
  • Was it surgical or percutaneous (may have implications for ease of re-insertion)?
  • The type and size of tracheostomy tube & availability of spare & emergency equipment
  • Is there an inner tube and, if so, does it need cleaning?
  • Is the tube secured (sutures or ties)?
  • Check the cough effort and sputum load
  • Check the patient's ability to swallow, including any SALT assessments
  • Check that the stoma dressing is clean

Remember, any sign of deterioration can be due to a tracheostomy or airway problem. Remember 'Red Flags'.

Where can you find this information?

Bed head signs should be available at the patient's bed space to quickly and easily communicate this information.

Previous handovers and the medical, nursing and allied health notes are useful sources of information. Some Trusts and specialist areas are moving towards integrated care pathways for patients.