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Chapter 13 - Care of the patient with a tracheotomy

Published online by Cambridge University Press:  25 October 2011

Peggy A. Seidman
Affiliation:
Stony Brook University, State University of New York
Elizabeth H. Sinz
Affiliation:
Pennsylvania State University
David Goldenberg
Affiliation:
Pennsylvania State University
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Summary

The tracheotomized patient faces many challenges in maintaining a semblance of normal airway function. Normal airway secretion management and reduction of excessive or tenacious secretions are important in the care of a patient with a chronic tracheotomy. Secretions are substances normally produced and released by cells, and in the respiratory tract are primarily represented by mucus. Therapies available to augment secretion removal can be divided into four different groups: expectorants; mucolytics; mucokinetic agents; and mucoregulators. Ventilation via a tracheotomy eliminates the necessary functions of the nose, including humidification of inspired air. The three broad classifications of humidifiers are: bubble humidifier; passover humidifier; and heat and moisture exchange (HME). The three main controversies in suctioning involve routine suctioning versus as needed, closed versus open suction systems, and instillation of normal saline when suctioning. Unlike many surgical wounds, a tracheotomy involves the creation of the wound with planned healing by secondary intention.
Type
Chapter
Information
Tracheotomy Management
A Multidisciplinary Approach
, pp. 165 - 179
Publisher: Cambridge University Press
Print publication year: 2011

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