Review indicators

Indicator 1. The patient’s tracheostomy wound appears red, tender, swollen, inflammation, smell, high skin temperature, yellow-green secretions can be seen around the stoma, or the patient has fever, the nurse immediately informs the doctor.

Indicator 2. The patient has signs of infection at the tracheostomy site, follow the doctor’s advice for bacterial culture.

Indicator 3. When the patient has decreased blood oxygen saturation, decreased blood oxygen partial pressure, frequent coughing and respiratory distress, the nurse should perform airway suction for the patient.

Indicator 4. When the patient needs to suck sputum, the airway pressure is low and the spontaneous breathing is weak, increase the cuff pressure appropriately.

Indicator 5. After the patient turns over, wipes the bath, and transfers, the nurse should re-measure the cuff pressure.

Indicator 6. Patients who have established artificial airways undergo continuous oxygen humidification and follow the doctor’s instructions to inhale 2 - 3 times per day.

Indicator 7. The artificial airway humidification fluid uses 0.45% sodium chloride solution for continuous airway humidification.

Indicator 8. When the patient has sputum in the airway, it should be sucked in time, and the sputum suction time is ≤15 s. Patients with no sputum or little sputum should perform a suction at least 8 hours.

Indicator 9. Oral suction before turning over and after oral care.

Indicator 10. Establishment of artificial airway patients use subglottic suction tracheal tube.

Indicator 11. Use special tracheostomy gauze when changing dressings for tracheostomy wounds, and keep the skin at the tracheostomy site dry.

Indicator 12. Patients with mechanical ventilation use chlorhexidine mouthwash for oral care once for 6 h - 8 h.

Indicator 13. The nurse evaluated the skin of the patient daily and kept the wound clean and dry and replaced at any time in case of contamination.

Indicator 14. Use a manual measurement cuff pressure gauge to monitor the airbag pressure every 6 - 8 hours and maintain it at 20 - 30 cm H₂O. The inflation pressure should be higher than the ideal value 2 cm H₂O during each measurement.

Indicator 15. When monitoring the cuff pressure, clean the water in the pressure measuring tube in time.

Indicator 16. The nursing class monitors and records the cuff pressure once after the tracheotomy wound dressing is changed.

Indicator 17. Cuff pressure monitoring cannot use finger touch to determine the degree of inflation.

Indicator 18. Nurses regularly evaluate airway humidification and adjust dynamically.

Indicator 19. The patient has a large amount of secretions in the airway and the nurse needs to perform deep suction.

Indicator 20. The nurse needs to measure the length of the suction tube inserted into the patient’s airway before suctioning

1) Insert into the carina and retract the suction tube 1 - 2 cm

2) Measure the same tracheal tube to estimate the length of the suction tube.

Indicator 21. The nurse pre-oxygenated the patient with pure oxygen for at least 30 seconds before and after suction.