Fiske Elizabeth
East Tennessee Children's Hospital, Knoxville, TN 37916, USA.
Adv Neonatal Care. 2004 Feb;4(1):42-53. doi: 10.1016/j.adnc.2003.11.011.
In neonates tracheostomies are most often indicated to provide a stable airway for infants with congenital or acquired airway obstructions and to provide long-term mechanical ventilation. Learning to care for an infant with a tracheostomy can be challenging for both professionals and families. This article provides an overview of tracheostomy care and the essential elements of family teaching. The surgical procedure and basic anatomical changes are reviewed. Complications such as accidental decannulation, mucus plugging, infection, bleeding, and granulation tissue formation are discussed. Humidification is critical for the infant with a tracheostomy and humidification delivery methods are discussed. Further, an overview of the impact of the tracheostomy on normal development, such as swallowing and language development, is provided. Teaching parents to safely care for the infant with a tracheostomy at home requires careful planning and systematic education. The parents must acquire a unique set of technical skills demonstrating competence and comfort in providing stoma care, suctioning, and tube changes. Parents must be prepared to initiate cardiopulmonary resuscitation (CPR) and need to understand alterations in CPR techniques in infants with a tracheostomy. They also need to develop critical thinking skills to handle emergency situations. A safe transition to the home can be accomplished by using a multidisciplinary approach to coordinate all facets of care.
在新生儿中，气管切开术最常用于为患有先天性或后天性气道阻塞的婴儿提供稳定气道，并用于长期机械通气。对于专业人员和家庭来说，学习照顾气管切开术婴儿都可能具有挑战性。本文概述了气管切开术护理及家庭教学的基本要素。回顾了手术过程和基本解剖学变化。讨论了诸如意外脱管、黏液堵塞、感染、出血和肉芽组织形成等并发症。湿化对于气管切开术婴儿至关重要，并讨论了湿化输送方法。此外，还概述了气管切开术对正常发育的影响，如吞咽和语言发育。教导父母在家中安全照顾气管切开术婴儿需要精心规划和系统教育。父母必须掌握一套独特的技术技能，在进行造口护理、吸痰和更换气管导管时展现出能力和自信。父母必须准备好实施心肺复苏（CPR），并需要了解气管切开术婴儿心肺复苏技术的改变。他们还需要培养应对紧急情况的批判性思维能力。通过采用多学科方法协调护理的各个方面，可以实现安全过渡到家庭护理。
