Choose Victory over Victimhood. - Expressions of Sharon

Choose Victory over Victimhood. - Expressions of Sharon

......Somewhere off Barton Street : CROSSROADS

......Somewhere off Barton Street : CROSSROADS: Crossroads can be a terrifying place especially when you have no clue. Do I go this way or that?  Life is full of crossroads, and we have t...

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It’s the big game weekend | Expressions of Sharon

It’s the big game weekend | Expressions of Sharon

Bleeding Trach!

Felt sad yesterday at work.... My patient got hurt by a follow nurse..not sure what have but, was told that her Trach secretion was bright red blood Thursday to Sunday.   Her parent took her to the ENT on Thursday...told by ENT that she was suctioned too deep and that cause irritation, and if bleeding continues take her to ER they did on Sunday.  When I came in on Tuesday,  her secretion was blood tinge for most of the day and also on Wednesday.  We used cold saline flush during each suctioning, it helps some.  To all my fellow nurses have you ever seen bright red blood secretion cause by deep suctioning once via Trach?  They showed me pictures and yes it's was a lot of blood bright red in suction canister and tubing... I have not seen that much and bright red.  I  have seen minute amount noted for few days.  We all should know the damage it can cause by suctioning too deep, too frequently and wrong technique.

Sharing some helpful info here.

What should You look for if  you think your patient is in trouble?

Although your patient has an airway, there are still possible threats that may prevent adequate breathing.

Respiratory Distress

• Flared nostrils
• Rapid breathing or change in breathing pattern
• Noisy breathing
• Clammy and sweaty skin
• Restlessness

Mucus Plug

A mucus plug is a collection of mucus that has clogged the airway.

• May have symptoms of respiratory distress if unable to breathe easily
• Can be prevented through adequate fluid intake, proper suctioning, and coughing
• A mucus plug may be removed by suctioning the airway and loosening the secretions with saline

Bleeding

It is not unusual to have occasional blood-tinged or pink colored mucus. However, bright red blood may be a sign of serious damage to the airway.

Causes of bleeding may include:

• Dry airway
• Frequent suctioning
• Infection
• Excessive coughing
• Irritation from the tracheostomy tube
• Trauma to the tube
• Foreign body aspiration

How to Prevent Bleeding

• Suction when necessary and avoid frequent deep suctioning
• Use appropriate methods of humidification

Bright, Red Bleeding

• If you see bright red bleeding from your child’s tracheostomy it is important to contact your provider or call 911

Blood-tinged or Pink Mucus

• Provide gentle suctioning
• May use saline to loosen secretions
• Notify provider if it continues

Accidental decannulation

If the tracheostomy tube is not secured properly then it is easy for your child to cough, pull, or have the tracheostomy fall out. If the tracheostomy comes out partially or completely, your child may have difficulty breathing.

Prevention

• Make sure the tracheostomy ties are secure, dry, and intact
• If the ties are showing signs of wear such as thinning of the tie or tears, it is time to replace the ties.
• Do not allow anyone or your child to pull at the tracheostomy

Complications

• Symptoms of respiratory distress
• If the tracheostomy comes out, then replace the tube as you would perform a tracheostomy tube change.

Aspiration

This occurs when secretions or food particles from the stomach or esophagus enter the airway.

Signs of Aspiration

• Drooling
• Coughing or choking with swallowing
• Food contents in the secretions from the tracheostomy
• Frequent lung infections

Prevention

• Thickening liquids with artificial thickener or foods such as puddings, baby foods, yogurt, cereal, or jello
• Have your child sit upright during and after feedings for 30 minutes
• Encourage slow eating and small bites

What to Do If Aspiration Occurs

• Carefully watch your child’s eating and drinking
• Suction the tube until the secretions are clear of the liquid or food particles
• Change the tube if it is clogged
• Notify your provider if your child is showing signs of breathing difficulties
• Work with a speech therapist as recommended

Remember your child can also aspirate if they vomit. It is best to turn your child’s head to the side and suction as needed.

Infection

Since air inhaled through a tracheostomy is not filtered by the body, your child is at an increased risk for infections.

Signs of Infection

• Fever
• Foul odor
• Yellow or green secretions
• Redness or bleeding at the stoma site
• Fast breathing or change in breathing pattern
• Lethargy

If you feel that your child’s tracheostomy may be infected, please call your provider.

http://www.musckids.org/ent/tracheostomyhandbook/trouble.htm

Nurse talk : Making the most of working the holidays.

Nurse talk : Making the most of working the holidays.: Being a Nurse means sometimes working during the holidays....if your shift happens to fall on a holiday...I say make the most of if....costu...

Making the most of working the holidays.

Being a Nurse means sometimes working during the holidays....if your shift happens to fall on a holiday...I say make the most of if....costume, decorations and foods...you and your patient will definitely enjoy, especially if you are a home health nurse.   Are you working this holiday? What are your plans to stay in the holiday spirit?