Essential principles: tracheostomy care in the adult patient

This article aims to guide the nurse caring for a tracheostomy patient, following the main principles of nursing care.

Tracheostomy is a surgical procedure to create an opening in the anterior wall of the trachea. Owing to improvement in technological support, the number of adult patients receiving a tracheostomy has increased. This requires the critical care nurse to have an understanding of the essential principles of care for a patient with a tracheostomy tube in situ.

Literature search was conducted in Medline and Cinahl using the search terms tracheostomy OR tracheotomy AND procedure/nursing care/experience limited to English language and adult. Owing to the lack of empirical research on the care of patients with tracheostomy, evidence is limited and therefore expert consensus is utilized in much of the article.

This article considers the indications for a tracheostomy, identifies the component parts of a tracheostomy tube, discusses 12 essential principles of care for a patient with a tracheostomy tube in situ, and finally briefly describes the nurse's role in an emergency and when discharging a patient with a tracheostomy tube to a ward.

Performing a tracheostomy has an enormous impact on patients and their care.

Nurses caring for patients with tracheostomy require an appreciation of the breadth of knowledge needed to provide individual and safe care. It is also important to appreciate the lack of empirical evidence on which to base that care.