This is so so helpful...I have my check off tomorrow
@LevelUpRN2 жыл бұрын
Thank you!
@rubenmagtoto6240 Жыл бұрын
sterile dummy you mean.😎
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@candiceyoung8244 Жыл бұрын
I'm a stage 4 Larynx cancer survivor. And I've had this cleaning and suctioning many, many times during my year in hospital, and since of course. But I now do this myself. I' will be celebrating my 8 year cancerversay Oct 25th. All of you nurses and respiratory techs are amazing. Thank you all,,you're angels ❤❤oh and I cannot tell the way that suctioning feels,especially if you have to put saline in the stoma,the coughing is scary I'll be honest
@wunitheodore6917 Жыл бұрын
Get well
@Ann-qh3kb Жыл бұрын
Your amazing!
@candiceyoung8244 Жыл бұрын
@@Ann-qh3kb Thank you so much. I'm just a survivor. Ive been very blessed. I appreciate your kind comment
@maddiehill5726 Жыл бұрын
@@candiceyoung8244you are not “JUST” a survivor!!! You are amazing, congratulations on 8 years!!! You were meant to be here❤️
@candiceyoung8244 Жыл бұрын
@@maddiehill5726 that's very sweet of you, Thank you so much 💕
@Rawkr572 жыл бұрын
Appreciate you sharing knowledge to nurses! A couple small tips from an RT. When setting your suction pressure, measure it by occluding the suction tubing and not to open air. This measures how much potential suction pressure you're using on their airway to limit damage. Usually suction pressures are 80-100 for neonates, 100-120 for pediatrics, and 120-140 for adults. Lastly, once you've passed your catheter down and hit resistance or they cough, pull back slightly* and then begin suctioning. This prevents accidental suctioning near the carina.
@LevelUpRN2 жыл бұрын
We love interdisciplinary support! Thanks so much for these great tips, and for all you do as an RT!
@brgyamesco86082 жыл бұрын
Indeed!
@jeetendrab1513 Жыл бұрын
Great!
@Mike-tw2mw Жыл бұрын
Hello. Just wondering how suctioning upon insertion causes potential injury? Are there any resources that can be shared? I am a home care provider, my client insists on being suctioned upon inserting the catheter, and does not believe me when I say suctioning upon withdrawal is best practice to avoid damage.
@wemojay7937 Жыл бұрын
@@Mike-tw2mwStick to your practice protocol and direction. You are OYO when anything regrettable results.
@aliciareed5522 Жыл бұрын
As a “covid” nurse with no clinicals - this is GOLD! Thank you so much!
@LevelUpRN Жыл бұрын
Very welcome!
@not.zack..2164 ай бұрын
EMT here. Fresh out of school with little (no) experience of trach care. Not something they teach you in school, but something they expect you to know in the field !! Moved my first trach pt yesterday, very very overwhelming, could feel my heart in my stomach while helping this gentlemen. I guess it’s something that comes with time; but definitely a helpful video in making me feel more comfortable while interacting with trach patients. Thank u!!
@jamesm2889Ай бұрын
Top 3 Nurse channels on youtube, thanks Ellis
@LevelUpRNАй бұрын
Thank you for the amazing compliment!
@abigailmoten28752 жыл бұрын
Thank you SO much for this! I’m a new grad nurse going into in home care for medically complex children, many of whom have trachs, GTubes, and Vents. I was so worried I didn’t remember exactly how to do trach care and this helped refresh my memory SO much. I cannot thank you enough, seeing a visual example helped so much more than reading my skills book, I just couldn’t visualize it on my own. I owe you!
@LevelUpRN2 жыл бұрын
Good luck in your new endeavor and congrats on becoming a nurse! In this video, I demonstrated reusable inner cannulas, but most folks are using disposable ones. So just skip that step (because you'd throw away the old one and get a new one). - Ellis
@ashageorge5395 Жыл бұрын
Where are you working
@selomunhagos2142 Жыл бұрын
@@LevelUpRN do you need to hyperoxygenate before cleaning and suctioning the tracheotomy
@gratitudetouniverse37546 ай бұрын
@abigailmoten2875 Hello. How do you like pediatric home care ? I am thinking of working also in pediatric home care. Is it a good start to work in home care as a new graduate ? Hope you are doing well. Thank you
@rayhansberger295511 ай бұрын
Canula appeared to go in upside down. Should be pointed towards the lungs when reinserted (not up the throat)
@miriellecharlot69874 ай бұрын
I saw that too
@sarahbarnes36053 ай бұрын
Thank you. I saw that too
@kawiracarolyne2524Ай бұрын
I had to quickly run into comment section to confirm am not the only one who saw that. Almost thought anatomy had played tricks on me.
@vanessa_the_mindset_maven Жыл бұрын
I really appreciate these videos! Even though I have been a nurse since 2011, I love to brush up on my skills. You can never know everything, I always say.Thank you!
@MsLadytray2 жыл бұрын
I'm a newer nurse that started in a clinic, I am now a classroom nurse and one of my cases has a trach so needless to say I need to refresh, so I that I can provide quality care. Thank you so much for this. I will be watching this and follow along with my kit from school.
@annaopoku9074 Жыл бұрын
Very well explained. Even a slow learner could understand. You spoke slowly and that was very good. GREAT JOB. KEEP IT UP.
@LevelUpRN Жыл бұрын
Yay! So glad it was helpful! Fee free to share a link to our channel with your classmates and friends in nursing school. ❤️
@bassclefbaby4 ай бұрын
Thank you! I have a trach. patient at clinical today and I wanted to solidify my skills before aiding in care in real-time. I appreciate you guys :)
@jeannineroberton40197 ай бұрын
Anytime you're working with vulnerable people the #1 priority is safety and sterile or clean work field. Thank you for the presentation.
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@LasEnchiladas Жыл бұрын
I am in my final year of Nursing school, this is one of the procedures we are learning in our Foundations 3 class....I found your video to be most helpful. Thank you so much!
@LevelUpRN Жыл бұрын
You are so welcome!
@lindawolffkashmir2768 Жыл бұрын
The way I was instructed to clean the stoma and keep the field sterile was a double wipe system with the gauze. Use a mix of sterile water and hydrogen peroxide on the first pass, always moving from the stoma outward, then the second pass sterile water only. Use the gauze, fold it so there’s always a clean surface on the neck. Soak the inner tube in the sterile water/H2O2 solution, scrub with brush, rinse in the sterile water, then re-insert. I may have to use the included tie when changing the neck band, because I’ve already had one incident where he coughed the whole trach tube out. (he didn’t hold onto it as instructed)
@klfrteduc2409 Жыл бұрын
you should check with your hospital's policy for trach care, most do not use hydrogen peroxide anymore during trach care. It is very caustic to the skin. If it is a non-disposable inner cannula that is crusty then you can soak it in a mixture of this, only if the brush didn't remove the dried secretions. the mixture, if you must use it, should be 1 part H2O2 to 3 parts water but try not to get it on the skin.
@susanmugo6570 Жыл бұрын
You did it really well .maintaining sterility by guarding the sterile hand🎉🎉🎉🎉🎉
@doremifasolatido-ro7zs7 ай бұрын
Im here to refresh my knowledge on how to perform proper trache suctioning and care because soon im going to apply a job in an LTC for the first time and i probably encounter some patients on traches so thank you for this demonstration it's really helpful.
@comicalcosmonaut959 Жыл бұрын
Hi quick question, Wouldn't it be easier to use clean gloves to pour on the saline and h2o2 into the tray, remove the old dressing and throw it away, remove the inner cannula and place it in the tray, discard the clean gloves and THEN set that sterile drape first? Just so when you don sterile, you wouldn't need to break sterile to removing the old dressing
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@pianoprimo17157 ай бұрын
Great Video but the inner cannula was upside down when you removed and reinserted. Was it not?
@Glamchar0073 ай бұрын
I was looking for this comment it definitely was.
@Furaway2 ай бұрын
Yes. Need to twist it then locked
@terisasam5604 Жыл бұрын
I'm glad I found your site to help me refresh on rarely used skills. Thank you Ellis.
@LevelUpRN Жыл бұрын
Welcome!
@inspiredx3866 Жыл бұрын
Great how-to while using the kit. However i wish it were across the board of RN and RT to agree to consider this a "very clean" technique, not "sterile".
@LevelUpRN Жыл бұрын
I appreciate this comment! We talk about this a lot, actually - especially with "sterile wound change". This seems to be stressed in school, but at best we follow clean technique at the bedside. If something needs to be "sterile" then it needs to be done in the OR. - Ellis
@StarlightPeach6 ай бұрын
Invaluable information in caring for my Dad. Thank you for sharing this.
@binitapoudel1 Жыл бұрын
I studied nursing in a foreign country. This video really helped me to learn new ways of suctioning. Thank you very much for your help.
@LevelUpRN Жыл бұрын
You're very welcome!
@yanbingzhu2550 Жыл бұрын
Is the direction of the tracheal tube correct? Why does it bend towards the pharynx? Shouldn't it bend towards the trachea?
@elizabethmcdonald24636 ай бұрын
It was not
@garnettwilcoxen28605 ай бұрын
I noticed that too
@wisconsin_girl91864 ай бұрын
You should be monitoring his O2 during the suction....
@kinleydorji19967 ай бұрын
I think you shout still monitor his spo2
@maricris19402 жыл бұрын
Thank you for the video. Big help for new acute nurses.
@LevelUpRN2 жыл бұрын
Glad it was helpful!
@louisecooper673710 ай бұрын
Great video!! Also you're a wonderful teacher, Ellis, and I appreciate you clarifying teaching moments vs real life moments.
@LevelUpRN10 ай бұрын
You are so welcome!😊
@wemojay7937 Жыл бұрын
Good educational video in terms of content and instructions. The camera could have bee zoomed to close up on certain pieces, parts, and areas mentioned from time to time. Kudos 🎉
@becka559782 жыл бұрын
The trach tube is in upside-down. It should be pointed down toward the lungs not up
@LevelUpRN2 жыл бұрын
Hi there! Unfortunately, this particular mannikin's throat does not allow for the rotation of the trach tube. But good looking out!
@Jess-wi3re Жыл бұрын
I wondered this same thing!
@IronDuke18153 ай бұрын
Excellent refresh, thank you.
@SpukiTheLoveKitten755 ай бұрын
I'm not a nurse but this info will be helpful for caring for my dad. Until his regular caregiver starts coming to his house, I'll be doing the honors.
@chakolaparis3213 Жыл бұрын
Thanks have to do clinical check off and this helped with my cards
@LevelUpRN Жыл бұрын
Great! Thanks for watching.
@SummerLove2175 ай бұрын
Very good changing & suctioning video.
@tropicallymixed. Жыл бұрын
Thank you!! Good video, I like that there was actually suctioning.
@LevelUpRN Жыл бұрын
Glad it was helpful! :)
@redheavenrose5 ай бұрын
isn't the cannula supposed to be facing downward
@jm-ib6wuАй бұрын
Yes
@jasminedahri38953 ай бұрын
thanks alot for sharing doctor.
@charmondkingren21053 ай бұрын
Hey. Please hold tight to the faceplate when ever you manipulate the inner cannula or change trach ties.
@Muhammadthorieq10973 ай бұрын
Thank you, i really need this ❤
@menjeri4923 Жыл бұрын
Thank you for sharing the information. Your videos are very helpful
@LevelUpRN Жыл бұрын
You are so welcome! Happy they are helpful. Please feel free to share a link to our channel with your classmates and friends in nursing school. :)
@Rayjaybud5 ай бұрын
Placement of canula was wrong. And dropping stuff on floor is a nono because guaze is dirty. Plus I would never use my elbow to pull down gown. Pull it down slightly before putting on sterile gloves
@simonedurham39345 ай бұрын
Thanks for the skill video I needed it
@LevelUpRN4 ай бұрын
So happy to help!
@autumnsun8640 Жыл бұрын
Very helpful. Thank you.
@LevelUpRN Жыл бұрын
You're welcome!
@jasminedahri38953 ай бұрын
i had my experience for pantient last 3yrs ago.
@cherylmcewan54835 ай бұрын
Thank you so much for this video
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@diannatoma2831Ай бұрын
Hello, I just was wondering when she inserted the trach did she insert it facing up or down? I was trying to rewatch it over and over but couldn't detect what she did. Please advise!
@simranjitgill93387 ай бұрын
Great information
@LevelUpRN6 ай бұрын
Glad you think so!
@lovelymimi34449 ай бұрын
Thank you
@fadyenaya2155 Жыл бұрын
so helpful thank you so much
@LevelUpRN Жыл бұрын
You are welcome!
@Pureemelaa2 ай бұрын
I was taught to place tube facing down in shape of the throat. Here it was shown pointed up in the throat. Not sure that is correct. Am I wrong?
@pramilarai548510 ай бұрын
How much should we insert the catheter into tracheostomy tube & endotracheal tube??? Is it same length or different??
@furwinner192 жыл бұрын
Thanks for sharing. Good demonstration.
@furwinner192 жыл бұрын
Question about suction in between I read in ATI IS 10 sec suppose to be.
@LevelUpRN2 жыл бұрын
Great question! Best practice is just less than 15 seconds. - Ellis
@ssecnirpeve03 Жыл бұрын
Some trach kits have two sterile field (paper). One for sterile and the other one can be used for used/unsterile items. I think its more hygienic and infection control is followed if we drop or put the used items on the other field (paper) or to the sterile part of the cover of sterile gloves than drop it on the floor cause there is instances that it will not shoot on the garbage can. Thanks.
@diksha32677 ай бұрын
Helpful 🙂
@pedrometro Жыл бұрын
Just wondering, why the curve of the inner tube is upward? should it be down ward as per anatomy
@temmy9983 Жыл бұрын
they probably put it in wrong tbh but it should be curved downward
@LevelUpRN Жыл бұрын
It is inserted upward and rotated to face down.
@Nita_B2 жыл бұрын
I will be performing this skill today during my validation. Thanks a lot for coming through with this demo 🙌🏾🫶🏽💯 love your videos.
@LevelUpRN2 жыл бұрын
You're so welcome!
@yasmanygarcia82578 ай бұрын
Word of advice, suction the patient before cleaning him 😂. This video was awesome 👌
@vanessasmith477310 ай бұрын
Very helpful, only please bring the camera closer so we can see what you are doing, thanks!
@annalanzotti-venrick39892 жыл бұрын
Thank you for the video!! Very helpful. Well done ❤️
@LevelUpRN Жыл бұрын
Thank you so much!
@solomon116111 ай бұрын
you are so funny still lots of learning happened.Cheers !!!
@atefkareem7257 Жыл бұрын
What about removing old tie first if the cuff inflated then can fix the new one, it's working or not.just asking and thanks for your great knowledge
@LevelUpRN Жыл бұрын
It's best practice to ensure there is a tie on at all times.
@textkestrel Жыл бұрын
Lovely instrucitonal video. Why did you elbow your patient at 2:53?
@LevelUpRN Жыл бұрын
Hi! Looks like I forgot to pull the gown down before donning my sterile gloves so I was trying to pull it down so you could better see what I was doing :)
@texasfred93212 жыл бұрын
You inserted inner cannula pointing up towards mouth. Instead of down towards lungs. Why?
@LevelUpRN2 жыл бұрын
Hi! On the manikins, it only goes into their "stoma" when pointing up. We have to insert it upside down, then rotate it. - Ellis
@sb84043 ай бұрын
Have u worked with a Montgomery T-Tube?
@cheyennes1505 Жыл бұрын
super helpful, thank you very much!!:)
@LevelUpRN Жыл бұрын
Glad it helped!
@reginaestrada2772 Жыл бұрын
OMG you have the "Rising Woman" symbol tattoed! ✨ Awesome !
@LevelUpRN Жыл бұрын
I do!! You're the first person to recognize it! My wife has the same symbol on her forearm with Artemis' bow completing the circle. - Ellis
@yalondaagnew Жыл бұрын
Can I remove the cut piece of gauze around the trach, before I create a sterile field?
@LevelUpRN Жыл бұрын
Yes, you can remove the soiled dressing before setting up your field. Just don't remove the tie until you're ready to replace it. - Ellis
@ashleymelendez45452 жыл бұрын
Question: should we be hyperoxgenating the patient throughout the care?
@LevelUpRN2 жыл бұрын
Ashley, there are cases where that is possible depending on the equipment being used. I do generally leave the mask closer to their trach than I did in this video so the view would not be blocked. However, we cannot leave the mask on as we do not want to touch it and break sterility. - Ellis
@klfrteduc2409 Жыл бұрын
@@LevelUpRN you should increase the Pts oxygen amount to 100% prior to Sx the Pt so when you do remove the mask to Sx they are less likely to desaturate. This is what is taught to Respiratory Students in their clinicals. When I teach trach care to RNs I tell them to do this as well.
@ashleywashington2843 Жыл бұрын
So you suction after you clean the tube
@kingstonstreet372610 ай бұрын
Where is the playlist of clinical skills?
@solangeteneck22362 жыл бұрын
Ty, this helps alot to refresh
@LevelUpRN2 жыл бұрын
Great!
@XxDarkRaverxX Жыл бұрын
If they had a velcro tie but the kit doesn't come with a velcro tie do you reuse the velcro tie or make do with the non velcro tie? What if velcro is preferred?
@LevelUpRN Жыл бұрын
If the trach ties need due to be replaced due to being soiled, then using the non-velcro tie is probably most appropriate.
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@noyonbarua2360 Жыл бұрын
Please ship to Canada!
@NURSINGcarely3 ай бұрын
www.youtube.com/@NURSINGcarely
@ttabaleka7 Жыл бұрын
What about when the tube is removed for cleaning and strong foul smell follows...
@LevelUpRN Жыл бұрын
If this were to happen and we were not aware of infection then I would immediately inform the partitioner of that occurring.
@manjunathgomanjunath65408 ай бұрын
Nice
@LevelUpRN8 ай бұрын
😊
@HeatherDalamanzi4 ай бұрын
My tracheostomy was cleaned to much to that extent that I am having some heartburn even when am talking
@michaelt2053 Жыл бұрын
Anyone have experience with the Passy Muir Speaking Valve? After a few short months my 77-year-old sister is hardly able to use it anymore because it irritates her throat. Sad. Could this have been due to treatment shortcomings? Such as insufficient humidification or suctioning. Or is this to be expected with frequent use over a few months? I really miss our phone calls.
@smoothmove92582 жыл бұрын
In reality, I saw some RT squeeze NS into the inner cannula prior to suctioning. Is it supposed to do it?
@deniserjbertoni91052 жыл бұрын
No that's not the current and best evidenced based practice guideline Saline instillation can make a patient cough but the introduction of the suction catheter will make people cough so saline is not necessary and not considered best evidence based practice
@jayta78 Жыл бұрын
Insertion of the inner cannula direction is definitely not correct. You may want to correct this or update your video to note this is not the correct direction to insert. Usually you insert with the curve upward direction and rotate as your anatomy would have the cannula curving down.
@LevelUpRN Жыл бұрын
Yes, you are right - it is inserted upward and rotated down. If I didn't rotate it, it's because the manikin is very stiff and does not allow for that movement.
@springsummer180310 ай бұрын
For nurses who wants to take an nclex exam, this is highly recommended KZfaq channel. This group are made up of nursing preceptors. Thanks for the effort of LEVEL UP RN
@thepalettewhispererasmr122711 ай бұрын
at what point is it ok to become 'non-sterile-?
@MzVan21 Жыл бұрын
What does a lavage it...?
@brittenyhowell2150 Жыл бұрын
The doll looks so realistic I keep thinking it could open its eyes at any moment
@LevelUpRN Жыл бұрын
Yes... Thanks for watching!
@Crazysiblings127 Жыл бұрын
WEAR UR PPE MISS, HOW CAN U PERFORM THIS PROCEDURE WITH OUT PRPTECTING URSLEF AND PATIENT
@temmy9983 Жыл бұрын
yeah corret ppe is a face shield/goggle and a mask
@nickzz18 Жыл бұрын
the way she just lift the head 😂😂
@lisagiordano2875 Жыл бұрын
MUCUS, not mucosa....
@simplyshanbrown36845 ай бұрын
😂😂
@heidih30485 ай бұрын
She keeps saying "mucosa" instead of "mucus." Mucosa is the tissue type, not the secretion.
@da-liyaJoseph2 жыл бұрын
But this is not a sterile way
@kurtenzena7345 Жыл бұрын
its nice to have those tray packet wherein everything u need is in it.,,, nhs where I work? they dont have those😂😂😂😂 u have to prepare one by one, so most of the time sterility is broken, also most of the time u need to rush and suction the patient before they choked with their secretions😂😂😂😂😂
@LevelUpRN Жыл бұрын
I've seen a movement in facilities where they don't use trays for procedures (like trach, CVC, or wounds) because of the waste that was occurring when not all of the tray equipment was being used (or even necessary). I agree that sterility is a goal, but is often not accomplished. - Ellis
@roxyhoard9993 Жыл бұрын
Mucus vs mucosa...hopefully there is no mucosa in that inner cannula😂
@Ayanyak.2 жыл бұрын
9:50
@jacquelinosei95492 жыл бұрын
Why do you hyperoxygenate ?
@LevelUpRN2 жыл бұрын
Hyperoxygenation before suctioning reduces the chance of hypoxia.
@jacquelinosei95492 жыл бұрын
@@LevelUpRN okay thank you ❤️❤️
@user-ny2jt7wt4h Жыл бұрын
WOW, thank you for sharing, but watch your videos before posting, you contaminated your gloves, and your trach cannula was facing upwards, Students watch these very closely, they take all of it to heart. Don't rest your sterile hand on the patient's Chest. Only teach the way you practice in real life.
@LevelUpRN Жыл бұрын
The inner cannula is inserted facing up then rotated to face down.
@tracymckenna84562 жыл бұрын
In my 36 years of nursing I have never seen teach tape/Tues applied like that…
@yemariam2110 Жыл бұрын
🤣 just witnessed 😳 u broke sterile field. But thank you for the video.
@allymaciolek31802 жыл бұрын
You broke sterile field way too many times 🙄
@tanyascott53492 жыл бұрын
I saw that too!
@abigailmoten28752 жыл бұрын
I don’t see a single moment where she broke sterile field?
@valeriefoster7923 Жыл бұрын
In the home it isn't really sterile.....
@JulietteLatte Жыл бұрын
She talks about breaking sterility at the end
@irfanberd Жыл бұрын
Don't you need a mask for this procedure?
@Officialjacquez1 Жыл бұрын
Great Demonstration! I am learning a lot by watching these Level Up RN videos🫶🏾🩺