[ Ссылка ] 'animatie'-case:
'hoe goede voorlichting van levensbelang kan zijn'.
this educational film is aimed specifically at laryngectomy patients with a permanent breathing stoma. For this patient group, the breathing stoma is their only airway. This method is somewhat similar to that for tracheotomy patients, but their breathing stoma is generally non-permanent.
Tracheotomy patients have a cannula (often inner and outer cannula). The inner cannula may be removed, but not the outer cannula.
This information describes aspects of oxygen administration to laryngectomy patients.
This method differs somewhat from a tracheotomy.
Laryngectomy patients have had their larynx removed.
Laryngectomy patients breathe solely through an opening in their neck, the stoma.
It is useless to administer oxygen and/or breathe air into patients through their nose and/or mouth.
Laryngectomy patients frequently wear a plaster, tube or button with a protective filter.
Various types of filters, also termed HME or artificial nose, are available.
For oxygen administration: remove the filter.
The plaster, tube, or button can be left in place.
Special devices can be used on the plaster, tube, or button for oxygen administration.
Ask the laryngectomy patient if he/she has these devices on him/her.
These devices may also be available through the hospital ENT department or the patient association.
If these devices are not available, a standard oxygen tube can also be used in combination with a filter.
If these materials are unavailable or the laryngectomy patient has no plaster tube, or button, use an oxygen tube and place it over the tracheostoma.
A risk associated with dry oxygen administration through a tracheostoma is that mucus dries in the windpipe, forming a hard plug, which can become lodged and cause airway constriction and shortness of breath, or even airway obstruction.
The airways may be inspected using a lamp or fibrescope. It is strongly recommended not to administer oxygen for longer than one hour without adequate air moistening in view of the risk of drying mucus, which could lead to crust formation in the trachea. Air must be moistened after one hour.
Dried mucus in the trachea, leading to shortness of breath may be prevented by:
- Oxygen administration using special devices such as a filter (with oxygen connection).
- Use of moisturised oxygen (caution: do not administer moisturised oxygen through a filter; the filter will become too wet, causing difficult breathing).
- Regularly dripping saline solution.
Fill 2 cc syringe with saline solution.
If there is a filter, remove it.
Use the syringe to drip saline solution to induce a cough reflex.
Collect the secretion with a piece of gauze or remove it by suction.
Repeat as needed.
Place back the filter, where applicable.
Should you have any questions as a result of this educational film, please contact the patient association (030-2321483, info@patientenvereniging-nsvg.nl) or the ENT department of a head and neck centre. Contact information can be found on the website www.nwhht.nl
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