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Going home with a Tracheostomy While in the hospital you or a caregiver will learn how to care for your tracheostomy (track care). When you go home your community nurse or respiratory therapist will
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How to fill out tracheotomy form

How to fill out a tracheostomy:
01
Gather all necessary supplies, including sterile gloves, sterile saline solution, sterile tracheostomy tube, tracheostomy dressing, and securement device.
02
Wash your hands thoroughly with soap and water before starting the procedure.
03
Position the patient properly. Ensure they are in a semi-reclined position, with their head slightly flexed and supported if necessary.
04
Cleanse the tracheostomy site using sterile saline solution and sterile gauze pads. Gently remove any crust or debris around the stoma site.
05
Put on sterile gloves to prevent any contamination. Carefully remove the tracheostomy dressing and inspect the stoma site for signs of infection or skin breakdown.
06
Deflate the cuff of the tracheostomy tube if the patient is using a cuffed tube. This allows for easier insertion and removal of the inner cannula.
07
Insert a clean tracheostomy tube into the stoma, making sure it is the correct size for the patient. Secure the tube in place using the appropriate securement device.
08
Reinflate the cuff if necessary, ensuring it is adequately inflated to provide a proper seal but not overly inflated to avoid causing unnecessary pressure on the tracheal wall.
09
Connect the tracheostomy tube to the ventilator or oxygen source if the patient requires mechanical ventilation or supplemental oxygen.
10
Apply a new sterile tracheostomy dressing around the stoma site to absorb any secretions and maintain a clean environment.
Who needs tracheostomy:
01
Patients with upper airway obstruction: Tracheostomy may be necessary for individuals with conditions that cause a blockage in the upper airway, such as tumors, trauma, or swelling due to infections.
02
Long-term ventilator support: Tracheostomy may be performed on individuals who require long-term mechanical ventilation to support their breathing, such as those with spinal cord injuries, muscular dystrophy, or chronic lung diseases.
03
Respiratory failure: Patients experiencing acute or chronic respiratory failure may require a tracheostomy to assist with breathing and improve oxygenation.
04
Pulmonary toilet: Tracheostomy can be used for regular suctioning and removal of excessive secretions in patients with conditions that result in excessive mucus production, such as chronic obstructive pulmonary disease (COPD).
05
Decannulation management: Tracheostomy may be needed for individuals who had previously undergone a tracheostomy but still require close monitoring and management during the process of weaning off the tracheostomy tube.
Remember, the decision to perform a tracheostomy is made by healthcare professionals based on each patient's specific medical condition and needs. It is essential to consult with a healthcare provider for personalized advice and guidance.
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What is tracheostomy?
Tracheostomy is a surgical procedure to create an opening in the neck and windpipe to help a person breathe.
Who is required to file tracheostomy?
Tracheostomy is typically performed by a surgeon in a hospital setting.
How to fill out tracheostomy?
Tracheostomy is filled out by medical professionals during the procedure.
What is the purpose of tracheostomy?
The purpose of tracheostomy is to bypass any obstructions in the upper airway or to assist with breathing.
What information must be reported on tracheostomy?
Information such as patient's name, date of procedure, surgeon's name, and any complications must be reported on tracheostomy.
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