Care of patients with tracheotomy

Traheotomija je kirurški postupak kojim se radi otvor traheostoma na prednjoj stjenci dušnika. Po tehnici izvođenja razlikujemo klasičnu traheotomiju, konikotomiju i perkutanu dilatacijsku traheotomiju. Odabir tehnike izvođenja traheotomije ovisi o indikaciji i o stanju bolesnika. Traheostoma može biti privremena ili trajna. Privremena traheostoma se spontano zatvara nakon prestanka njene indikacije, dok se trajna traheostomija izvodi kod bolesnika kojima je učinjena totalna laringektomija. Traheotomija je danas rutinska operacija, međutim brojne su postoperativne komplikacije koje se mogu javiti kod traheotomiranih bolesnika. Postoperativne komplikacije dijelimo na rane i kasne, ovisno o vremenu kad se manifestiraju. Uloga medicinske sestre/tehničara u postoperativnom periodu je da provodi pravilnu njegu traheotomiranih bolesnika, prati vitalne funkcije i promatra izgled i stanje bolesnika. Medicinska sestra/medicinski tehničar provodi njegu i previjanje traheostome, aspirira dišni put, redovito čistiti i mijenja unutarnji uložak kanile, vlaži dišni put, provodi njegu usne šupljine i hrani bolesnika. Praćenjem vitalnih parametara i promatranjem bolesnika, medicinske sestre/tehničari prepoznaju rane simptome komplikacija u postoperativnom periodu. Tim postupcima medicinska sestra/tehničar prevenira komplikacije, rano prepoznaje pojavu komplikacija te omogućuju optimalne uvjete za oporavak bolesnika. Uz postoperativnu njegu medicinska sestra/medicinski tehničar sudjeluje u edukaciji bolesnika o pravilnoj njezi stome, a kao član multidisciplinarnog tima sudjeluje u edukaciji o načinu korištenja govornih pomagala, kao što su govorne kanile, govorni aparat i govorna proteza.Tracheotomy is surgical procedure used to make an opening tracheostoma on the anterior wall of the trachea. According to the technique of performance, we distinguish classical tracheotomy, conicotomy and percutaneous dilatation tracheotomy. The choice of the tracheotomy technique depends on the indication and the patient's condition. Tracheostoma may be temporary or permanent. Temporary tracheostoma is closed spontaneously after the termination of its indication, while it is permanently done in patients with total laryngectomy. Tracheotomy is a very safe operation nowadays, but there are many post-operative complications that can occur in tracheotomised patients. Complications are divided into early post-operative and late post-operative depending on the time they occur. The role of the nurse/technician in the post-operative period is to provide proper care for tracheotomised patients, monitor vital functions and observe the appearance and condition of the patient. The nurse/medical technician carries out tracheostasis curing and wrapping, aspires the airway, regularly cleaning and changing the internal cannula cartridge, wetting the airway, caring the oral cavity and feeding the patient. Monitoring vital parameters and looking at the patient's appearance, nurses/technicians recognise early symptoms of post-operative complications. With these procedures, the nurse/technician prevents complications, early recognizes the occurrence of complications and provides optimal conditions for the patient's recovery. In addition to post-operative care, the nurse/medical technician participates in the education of the patient about self-sufficiency, as a member of a multidisciplinary team participates in education on the use of speech aids, such as voice canals, voice apparatus and voice prosthesis