| Changing a tracheostomy tube is a monthly task in order to decrease any chance of infection. The patient should always have a back up tube of the same size next to the bedside, as well as a tracheostomy tube one size smaller. Unless the caregiver has had proper training, they should not attempt to change the tube. Changing a tracheostomy tube is a sterile procedure and you must utilize sterile technique to avoid infection.
Here we are going to describe the necessary steps needed to perform an emergency removal and insertion of a tracheostomy tube. Note that this procedure should be performed on a patient with an obstructed tracheostomy tube, in whom no effective ventilation / oxygenation is possible.
Equipment:
- Personal protective equipment / Body substance isolation
- Sterile tracheostomy tube (Same size and One size smaller)
- Sterile gloves
- Sterile water soluble lubricant
- Sterile field (PreHospital may be the Sterile Burn Sheet)
- Suction equipment
- 10 cc syringe
- Bag-valve-mask
- Sterile 4 x 4 gauze
- Tracheostomy tube holder / ties (if applicable)
- Tracheostomy dressing
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