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Tracheostomy home care: in a resource-limited setting
A Vanker1, S Kling, J R Booysen
1Faculty of Health Sciences, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg Children's Hospital, PO Box 19063, Tygerberg 7505, South Africa. aneesa@sun.ac.za
Archives of Disease in Childhood
|September 28, 2010
Summary
Children with tracheostomies can receive safe home care in South Africa. A home tracheostomy program demonstrated an 82% survival rate, highlighting the importance of training and support.
Area of Science:
- Pediatric critical care
- Home healthcare services
- Resource-limited healthcare settings
Background:
- Home tracheostomy care in South Africa initiated in 1989.
- Tygerberg Children's Hospital (TCH) established a home tracheostomy program.
- Program operates in Cape Town, a resource-limited setting.
Purpose of the Study:
- Describe the tracheostomy home program at TCH.
- Evaluate the feasibility and outcomes of home-based tracheostomy care.
- Assess the impact of a resource-constrained environment on the program.
Main Methods:
- Retrospective descriptive study design.
- Analysis of data from the TCH tracheostomy home program.
- Inclusion of caregiver training by nurses as a key component.
Main Results:
- Fifty-six children entered the home program (median age 3 months).
- Successful decannulation in 43% of children; overall survival rate of 82%.
- Significant social work support generated (745 contacts).
Conclusions:
- Home tracheostomy care is viable for children in resource-limited settings.
- Effective caregiver training is crucial for successful home care.
- Adequate technology and social support enhance patient outcomes.
Related Concept Videos
01:16Tracheostomy Care I: Pre-procedural Steps
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
01:25Tracheostomy Care II: Procedure
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
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01:28Tracheostomy: Procedure and Tubes
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
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01:23Oxygen Delivering System III: Tracheostomy and T-piece
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01:21Tracheostomy Decannulation
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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
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