Using a tracheal tube with a tracheal puncture (Tracheostomy)
A tracheostomy is an opening in the front of the throat. so that patients with breathing problems can breathe more easily
neck piercing method The doctor will incision open the skin in the front of the neck. to bring a tracheal tube or throat tube A tracheostomy tube is inserted into the throat through the patient's trachea (Figure 1) to allow air to enter the patient's trachea and lungs.
This is so that the patient does not have to breathe through the nasopharynx and upper throat as in normal conditions. In addition A throat puncture also allows the patient to cough up mucus from the windpipe. or to allow the caregiver to suck out phlegm from the trachea as well
How many types of neck pipes are there and what are their characteristics?
Throat drill pipes can be divided into 2 types: (Figure 2)
- plastic model
- metal model
The throat drill pipe looks like a curved pipe. It consists of 2 layers of pipes, namely (Figure 2).
- Outer tube
- Inner tube
The two layers of pipe are stacked together. Can be disassembled for cleaning. Because patients with throat piercing will have phlegm coming out. Therefore, we must always clear the phlegm. to prevent obstruction of sputum especially when wearing a tracheal tube for a long time
Reason for neck piercing
Throat piercings are temporary treatments. But in some patients, permanent neck piercing may be required. The groups of patients with throat piercing are as follows.
- There is an object or a large object obstructing the airway.
- inability to breathe on their own or need to use a ventilator for a long time
- throat cancer, such as laryngeal cancer
- Paralysis of muscles involved in swallowing, vocal cords, or diaphragm
- Severe injury to the slit, neck or chest wall
- People who have had surgery around the larynx, neck, and skull
- The airways become swollen and blocked due to the suction of toxins or soot.
- There is a lot of phlegm in the trachea and trachea which needs to be aspirated frequently. especially unconscious patients
- Patients with lung infections and sputum that cannot be coughed up
- the spinal cord is destroyed
- Patients who are coma, unconscious, or paralyzed
- There are other problems, such as severe sleep apnea.
Risks and Complications
Complications after cervical puncture may occur immediately. and after throat piercing There are also complications from a tracheal tube.
- There is damage to the nerve from the puncture of the neck.
- have a respiratory infection
- Air leaks in the pleural area (Pneumothorax) or under the skin around the throat tube (Subcutaneous Emphysema).
- A lump of tissue that is abnormal in the respiratory tract
- The airway above the tracheal tube collapses.
- There is a lesion in the trachea due to friction with the tube.
- Dry sputum and mucus that obstructs the tracheal tube.
- The hole closes after the neck tube is removed.
Caring for the patient after cervical puncture (Tracheostomy Tube Care)
After neck surgery Patients must take care of themselves to reduce the occurrence of complications. Here's how:
- Speech Speech is not normal. This can be solved by using a valve to open-close at the end of the tracheal tube, which will allow the patient to speak normally.
- dining After throat piercing in the early stages The patient will not be able to swallow food normally. But over time, the patient will be able to swallow normally by practicing swallowing, which may start with small sips of water.
- activities The patient can lead a normal life, but during the first 6 weeks after the neck piercing, strenuous activities must be avoided. And must take care of the throat piercing wound clean and dry.
- Always try to keep your body warm. Avoid places that are very cold or dry.
- Try not to allow foreign objects or dust to get into the tracheal tube, for example by covering it with a cloth when going outside.
- Cleaning the piercing area The suction tube and tracheal tube should be cleaned regularly. This will reduce the accumulation of sputum and reduce the likelihood of infection.
- Cleaning the phlegm suction line Should be cleaned every time after use by using a sputum suction hose to bring the hydrogen peroxide solution until the sputum is completely removed from the inner tube. After that, suck the salt water to wash off the hydrogen peroxide completely, dry it and wrap it in a towel.
- Cleaning the bronchial tubes Wash your hands first and then soak the inner tracheal tube into the peroxide solution. Then scrub the pipe clean until the phlegm is completely gone. Then rinse with saline until the smell of the peroxide dissolves. Then wipe the pipe dry and reassemble it.
If you find any of these abnormal symptoms, you should see a doctor immediately.
- Feeling short of breath, having trouble breathing
- Infection at the wound site
- The outer tube is removed from the throat.
- Inner tube missing or not being inserted back
- Bleeding from the throat tube
- coughing or having unusually large amounts of mucus