Basic principles of respiratory care for patients with tracheostomy

Tracheostomy is a commonly performed procedure in the intensive care unit. Selection of patients for this procedure should be done carefully after understanding the individual risks and benefits. Optimal care begins with the selection of an appropriate tube for the patient from the wide range of tubes available today. Care of the cuff, proper patient positioning, humidification of inspired gases and a well secured tube would avoid undue complications. Adequate support needs to be given to facilitate communication and swallowing. Emergency equipment for tube change should be readily available. A good tracheostomy care plan also includes oral hygiene, infection control practices, wound care and provision of adequate nutrition. Decannulation may fail, if performed without proper assessment of functional and anatomical changes in the airway. A good understanding of the basic principles of respiratory care will provide better outcome in patients with a tracheostomy