Many patients in our department go home with tracheotomy cannulae, many family members consult how to care for tracheotomy after going home, I briefly talk about the main points of care for tracheotomy patients, you can refer to: a. Post-operative and home care: 1. Place the patient in a quiet, clean, fresh air hospital room, keep the room temperature at 21 ℃, humidity at 60%, tracheal set mouth covered with 2-4 layers of warm wet gauze, indoor sprinkling water frequently, or Apply humidifier, disinfect indoor air with ultraviolet light at regular intervals. 2.Beware of obstruction caused by tracheal tube: one of the reasons for obstruction is the air sac slipping off and blocking, the other is the secretion bonding into scab obstruction, such as sudden respiratory distress, cyanosis, patient agitation, the air sac of the casing should be taken out immediately for inspection. To prevent the balloon from slipping, attention should be paid to tie the balloon firmly, lead the thread out of the tracheotomy wound, and frequently tug to check whether it is firm and remove the crust in time. However, for patients at home, family members should not untie the ties at will to prevent the cannula from slipping out. 3.Timely aspiration: Patients with tracheotomy have difficulty in coughing and excreting sputum, and the sputum in the airway should be cleared at any time. 4.Adequate humidification: Tracheotomized patients lose the function of humidification, and the following methods are often used to humidify: (1) heating humidifier, family members can buy a set to facilitate humidification; (2) continuous humidification method, infusion of humidification solution through the scalp needle slowly dripping into the trachea, the drip rate is controlled at 4-6 drops per minute, not less than 200ml per day and night. 5.Prevention of local infection: If it is a metal cannula, the endotracheal cannula should be removed every The gauze of the tracheal tube should be kept clean and dry and replaced daily. The gauze around the plastic cannula should be replaced regularly. Check the skin around the wound frequently for infection or eczema. 6.Care for the patient and give spiritual comfort: the patient cannot pronounce after tracheotomy, written conversation or action can be used to indicate that if the patient is conscious, the condition is improving, the sputum is obviously reduced and the coughing ability is stronger, the tube can be intermittently blocked and the patient can pronounce. Prevent the patient from pulling out the cannula by himself due to impatience, and try to fix both hands if necessary. Common complications of tracheotomy 1, detubation: often due to poor fixation, detubation is a very urgent and serious situation, if not dealt with in time, asphyxia will occur quickly, stop breathing. The patient’s family should always check the tightness of the ligature, to allow only one or two fingers as the degree, do not lightly loosen. 2. Bleeding: It can be caused by incomplete hemostasis during tracheotomy, or damage to the tracheal wall by catheter compression, stimulation, or rough suction action. Patients feel pain at the sternal stalk or blood in sputum, and in case of hemorrhage, tracheal intubation should be performed immediately to stop bleeding by compression. If bleeding occurs, contact the surgeon or go to the local hospital promptly. 3. Subcutaneous emphysema: It is a relatively common complication of tracheotomy, and the site of emphysema mostly occurs in the neck, and may occasionally extend to the chest and head. When subcutaneous emphysema is found, the edges of the emphysema can be marked with nail violet to facilitate observation of the progress. Most of them can be absorbed by themselves. 4. Infection: It is also a common complication of tracheotomy. It is related to the disinfection of room air, the contamination of suction operation and the original condition. 5. Tracheal wall ulceration and perforation: inappropriate selection of cannula after tracheotomy, or longer placement time, and deflation and decompression when the air sac is not set can lead to it. 6. subsonic granuloma, scar and stenosis: this is a late complication of tracheotomy. III. Precautions for suction 1. Suction action should be gentle and rapid to reduce the damage to the tracheal wall. Generally, 12 or 14 rubber or silicone catheters with moderate hardness, smooth surface and relatively large inner diameter are used, or special suction tubes are used, and the thicker blind end of the front end of the catheter can also be cut off to make it into a crescent shape of inward concavity, and then two small holes are cut on both sides to reduce the negative pressure at the head end of suction and increase the suction area. If the patient feels pain at the sternal stalk and blood in the sputum, be alert to the possibility of bleeding, and once hemorrhage occurs, implement tracheal intubation immediately and carry out resuscitation measures such as stopping bleeding at the same time. 2. Pay attention to aseptic operation when suctioning, wash hands before operation, strictly sterilize the catheter, use one catheter only once, and adhere to the principle of inside-out when suctioning sputum, suctioning endotracheal secretions first and then nasal and oral secretions. 3.Before aspiration, one should take 3-5 deep breaths, and for those who use ventilator, one should hyperventilate for 2-3 minutes to increase the partial pressure of oxygen in the alveoli, and then quickly, accurately and gently aspirate the secretions with the aspiration tube. It is forbidden to lift and insert the sputum tube up and down. Aspirate for no more than 15 seconds at a time, especially for patients with respiratory failure, longer negative pressure suction can cause hypoxia, respiratory distress and asphyxia. 4. The suction tube must reach the depth of trachea before starting the suction device, or when starting the suction device, bend back the suction tube and the glass joint by hand so that it does not leak, and extend the suction tube into the trachea to a certain depth before releasing the suction. IV. Care for extubation Extubation should be carried out only when the condition is stable, the function of respiratory muscle is restored, the cough is strong, the sputum can be excreted by oneself and the dependence on tracheotomy is lifted, then the blockage test can be carried out. If there is no respiratory distress after 24-48 hours of blockage and you can sleep, eat and cough, you can remove the tube. The fistula after extraction is disinfected with 75% alcohol and can be healed in 2-3 days by pulling it together with butterfly tape.