Nursing the artificial airway patient

Abstract

Nursing the artificial airway patient presents many challenges. This article covers identifying patients at risk from airway obstruction who may benefit from an artificial airway and outlines the key considerations of managing these patients, including types of tracheostomy tubes, stoma site care, airway hydration and airway suctioning. Finally, potential complications and their management are considered in order to maximise successful outcomes in these patients.

Multiple Choice Questions

1.	Which of the following is not generally a reason for placing a tracheostomy tube? (a) Laryngeal paralysis or collapse (b) Hyperventilation (c) Brachycephalic Obstructive Airway Syndrome (d) Tracheal foreign body
2.	Which of the following would be a contraindication to tracheostomy tube placement? (a) Coagulopathy (b) A tracheal obstruction above the tracheostomy site (c) Trauma (d) Laryngeal paralysis
3.	What should the tracheostomy stoma site be cleaned with? (a) Povidone iodine (b) Chlorhexidine gluconate (c) 0.9% sterile saline solution (d) Antimicrobial handwash
4.	What percentage of cases develop at least one complication associated with tracheostomy tube placement? (a) 50% (b) 29% (c) 75% (d) 86%
5.	Which of the following is not a potential complication of tracheostomy tube placement? (a) Subcutaneous emphysema (b) Airway obstruction (c) Infection of the stoma site (d) Increased partial pressure of oxygen
6.	Suction pressure applied to the airways should be a maximum of: (a) 80mmHg (b) 120mmHg (c) 150mmHg (d) 100mmHg
7.	How often should heat and moisture exchangers be inspected? (a) Every 8 hours (b) Every 4 hours (c) Every 12 hours (d) Every 24 hours
8.	Deep suctioning of the trachea may cause which of the following complications? (a) Bradycardia (b) Tachycardia (c) Subcutaneous emphysema (d) Hypotension

For the answers to the MCQs, please go to: http://www.bvna.org.uk/publications/veterinary-nursing-journal

Additional information

Notes on contributors

Helen Silver

Helen Silver Dip AVN(Surg) Cert SAN RVN

Helen qualified as a veterinary nurse in 2000, went on to gain a Certificate in Small Animal Nutrition and then competed the RCVS Diploma in Advanced Veterinary Nursing (Surgical) in 2005. She is particularly interested in emergency and critical care and is currently studying for the Vets Now Certificate in Emergency and Critical Care. Having gained a wealth of experience in both first-opinion and referral nursing over the past 16 years, Helen now enjoys her position as a senior nurse at the Animal Health Trust.