Starting January 1, 2023, California has implemented new laws that bring significant changes for family caregivers, including expanded leave benefits, the appointment of healthcare surrogates, and conservatorship reforms. These laws are set to make a considerable impact on caregivers’ lives, offering more flexibility and rights.
Home Tracheostomy Care Guide for Children
Disclaimer: This guide is for informational purposes only and should not replace professional medical advice or training. Always consult healthcare professionals for medical decisions.
Introduction to Tracheostomy Care at Home
Embarking on the journey of providing at-home care for your child’s tracheostomy can be emotionally complex. This guide is designed to assist you in this process. Feel encouraged to express your emotions and ask questions to the healthcare team involved in your child’s care.
Preparatory Steps Before Leaving the Hospital
Prior to your discharge, you will engage in hands-on practice of the necessary care procedures under a nurse’s supervision. This resource aims to address common questions and prompt further inquiries. Do not hesitate to seek clarifications on any confusing aspects.
Understanding Normal Breathing
Normal breathing involves effortless inhalation through the nose, with air being humidified and warmed as it travels to the lungs. Oxygen is then transferred from the lungs to the bloodstream.
A tracheostomy involves creating an opening in the trachea (windpipe) through the neck. Post-healing, this opening is referred to as a stoma, maintained by a tracheostomy tube.
Types of Tracheostomy Tubes:
- Plastic trach tubes (Shiley)
- Silicone trach tubes (Bivona)
Differences Between Hospital and Home Care
In the hospital, sterile techniques are used, while at home, you’ll adopt clean techniques due to fewer germs in the home environment.
- Hand washing
- Sterile gloves
- New trach tube and ties
- Hand washing
- Optional gloves
- Reusable, cleaned trach tubes and ties
Tracheostomy Skin Care
The skin around the trach needs regular cleaning to prevent irritation. The process involves using mild soap, water, clean washcloths, and trach ties. Follow a gentle cleaning method, keeping the area dry.
Changing Trach Ties
Customize the trach ties to fit your child comfortably, ensuring they are neither too tight nor too loose. You may use a dry gauze dressing if there are excessive secretions.
Suctioning the Tracheostomy
Suctioning is vital for removing mucus, which can’t be expelled normally due to the tracheostomy. Be observant of signs that indicate the need for suctioning, such as visible mucus, respiratory distress, or changes in skin color.
- Proper hand hygiene
- Preparation of sterile suction catheter kit
- Measured and gentle catheter insertion
- Timely removal of the catheter to allow breathing
Changing the Tracheostomy Tube
This process should be calm and unhurried, ideally when your child is at ease.
- Sterile (or clean) trach tube with obturator
- Various necessary cleaning and lubricating supplies
- Clean hands and set up the area
- Comfortably position your child
- Replace the trach tube, ensuring it’s secured properly
Cleaning and Sanitizing Trach Tubes
Clean reusable trach tubes using appropriate methods for either plastic or silicone types, ensuring they are free from damage and thoroughly dry before storage.
Emergency Care Guidance
Be prepared for emergency situations like breathing difficulties, dislodged trach tubes, or unsuccessful trach tube insertions. Understand CPR basics and have emergency contact procedures in place.
Daily Life with a Tracheostomy
Adapt your child’s bathing, dressing, play, and sleep routines to accommodate the trach safely.
Providing tracheostomy care at home requires knowledge, practice, and confidence. Utilize this guide as a reference and always stay in close contact with your child’s healthcare team for guidance and support.
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