Aspirate

 

  • Even if there is no problem, aspirate every 3 hours at the latest. 
  • Aspirate if its saturation (SpO2) decreases, wheezing increases, secretion increases, and discoloration (bruising, ringing) occurs in the body. 
  • Wash your hands, put on your gloves. 
  • Use each glove only once. 
  • Use each neclaton only once. 
  • Make the aspirate from bottom to top.(Treceostomy, mouth, nose) 
  • After attaching the nelaton, do not touch the tip anywhere.
  • Squeeze one SF in two aspirates. 
  • Connect the ventilator after squeezing SF, wait for 5 seconds. 
  • Clamp the nelatone as it enters. (if not, it will stick and irritate.) 
  • Open clamp after advancing. 
  • Turn the nelatone as it goes up. 
  • Control the saturation and pulse throughout the aspirating process. Make sure that the saturation does not fall below 80. 
  • If you need to continue with aspirating, connect the ventilator.
  • When the saturation is 95, continue the process.
  • Treceostomy aspirate should not be longer than 20 seconds. 
  • Clean nelatone, aspirate from mouth. 
  • Do not go up to the throat, it can cause nausea and vomiting. 
  • If the nose is dry, squeeze out SF, aspirate. 
  • Clean the hose with boiled chilled drinking water, throw away the nelatone. 
  • Empty the aspirating bucket frequently.If possible, it can be cleaned after every aspiration to avoid infection.)

 

What to Do in an Emergency

 

  • Don't panic. 
  • Call 112. 
  • Write down your home address where you can easily find it.

 

If Pulse Drops With Saturation

 

  • Cut the formula. 
  • Aspirate. 
  • Ambulate 
  • If its saturation does not rise and the pulse does not exceed to 60, begin CPR (heart massage). 
  • Lay the child on his back on a hard floor with his chin facing the ceiling. 
  • Draw an imaginary line from the nipples and apply it with two thumbs under the junction of these two lines. (It would be more accurate to watch from the video.) 
  • Press 3 times so that it will go in 1/3 ratio, ambulate 1 time. 
  • Do not continue the massage while ambulating. 
  • Continue until his pulse rises. 
  • Do it until the 112 arrives.

 

If the Spigot Drops

 

  • When its saturation falls, If it does not increase despite aspirating, 
  • If no one comes to Nelatone, 
  • If there is bruising on his lips and nails, it may be that there is a plug. 
      1. Squeeze SF. 
      2. Ambulate the treceostomy. 
      3. Aspirate again. 
      4. Move swiftly without panicking. 

 

Ambulating

 

  • Keep the ambu easily accessible. 
  • Keep 1 ambu in the hospital bag. 
  • Check to see if the ambu is burst or not. 
  • In an emergency, call 112 without ambulating. 
  • If the gag pops out, if its saturation does not rise to the 90s after aspirating, ambulate it. 
  • If the cannula is removed and you cannot insert it, cover the tracheostomy hole with a sponge and ambulate orally.

 

Oral Ambulating

 

  • Inflate the Ambu mask with the syringe. 
  • Lie the child on his back, position him with his chin facing the ceiling. 
  • Connect the oxygen to the ambu. 
  • Make sure the balloon is inflated. 
  • Set the Ambu pressure to the highest. 
  • Place the mask so that it covers the mouth and nose. 
  • Press from the mouth and nose so that there is no gap. 
  • Ambulate as 1-2-3 frequently.

 

Ambulating from Tracheostomy

 

  • Connect the ambu to oxygen. 
  • Make sure the balloon is inflated. 
  • Bring the Ambu pressure to medium value. 
  • Attach the ambu to the cannula. 
  • Ambulate as 1-2-3 frequently. 
  • After the ambulating is over, connect the oxygen to the ventilator.

 

Tracheostomy Care

 

  • Maintain it twice a day. 
  • Wash your hands, wear gloves. 
  • Take the sponge, check for green or bad colored flow. 
  • If there is no problem, pour batikon to sterile sponge. 
  • Do not touch the spounge with the mouth of the batikon while pouring the batikon. 
  • Do not touch the sponge with batikon anywhere. If you do, prepare a new one. 
  • While one person holds the cannula, turn the sponge with batikon 1 full clockwise around the cannula. Do not touch the dirty sponge anywhere else on the patient after cleaning. 
  • Dry around the cannula with a clean sponge. Being moist can cause infection. • If there is any remaining thread, clean it with forceps. 
  • Place the new sponge. 
  • To change the neck tie, cut the gauze.You can also use a ready-made neck tie.) 
  • If there is a blushing place on your neck, apply cream. 
  • Place the tie, leaving one finger space to the left and right. 
  • Clean the scissors and forceps you used. 

 

Gastrostomy Maintenance

 

  • Maintain it twice a day. 
  • Wash your hands, wear gloves. 
  • Take the sponge, check for green or bad colored flow. 
  • If there is no problem, pour batikon to sterile sponge. 
  • Do not touch the spounge with the mouth of the batikon while pouring the batikon. 
  • Do not touch the sponge with batikon anywhere. If you do, prepare a new one. 
  • Turn the sponge with batikon 1 full clockwise, around the peg. Do not touch the dirty sponge anywhere else on the patient after cleaning. 
  • Dry around the peg with a clean sponge. Being moist can cause infection. 
  • • If there is any remaining thread, clean it with forceps. 
  • Place the new sponge. 
  • Clean the scissors and forceps you used.

 

General Maintenance

 

  • Clean the peg hose twice a day. 
  • When you give medicine, give water afterwards. 
  • Clean the inside of the mouth with a swab twice a day by adding baking soda to boiled chilled drinking water. 
  • To prevent pressure sores, change positions every 2 hours at the latest. 
  • Do postural drainage frequently. You can use the ambu mouthpiece as well as hands. 
  • Check the water of the humidifier frequently. 
  • Clean the filters of the ventilator and concentrator. 
  • Change food bags daily. 
  • Remember to bleed the air in the tubing when you put on a new set or add food. 
  • Against power failure, keep a flashlight easily accessible
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