How Should a Tracheal Tube Be Properly Cared For?

Nursing Care of Tracheal Cannula Mainly Includes Prevention of Decannulation, Care of Air Bag, and Airway Humidification

The nursing care of tracheal cannula is a professional and meticulous task that requires regular inspection and timely record-keeping, without neglecting any clue. Here are some key points:

1. Prevention of Decannulation: During the early stage of tracheotomy, observation should be strengthened to keep the incision dressing and surrounding skin clean and dry. The binding bandage after tracheotomy must be securely tied and properly fixed, allowing for the accommodation of one finger to avoid excessive tightness that could affect breathing or loosening that could lead to decannulation.

2. Care of Air Bag: To prevent postoperative wound bleeding from flowing into the lungs, the air bag should be inflated within 72 hours postoperatively. The degree of inflation should be such that the air bag has elasticity (similar to touching the lips), typically filling with 8-10ml. If it is not a high-volume low-pressure air bag, intermittent deflation or pressure adjustment should be performed to prevent long-term compression that could cause tracheal mucosal damage. If mechanical ventilation is not required, the air bag does not need to be inflated after 72 hours, which is beneficial for breathing. When eating or receiving nasogastric feeding, the air bag should be inflated, and the patient should be placed in a semi-recumbent position for 30-60 minutes to prevent food from entering the trachea.

3. Airway Humidification: Under normal conditions, the air humidity can reach 98% after passing through the nasal cavity and reaching the lungs. However, for patients with tracheotomy, the water evaporated directly from the tracheal cannula during daily breathing can amount to up to 1000ml, making the inner wall of the tracheal cannula prone to forming dry scabs. Therefore, airway humidification should be strengthened. Different frequencies and volumes of physiological saline instillation can be used based on the viscosity of sputum, gradually increasing from once every 4 hours with 2ml each time to once every 2 hours with 3ml each time, or increasing the frequency of aerosol inhalation from once every 6 hours to once every 4 hours.