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학습 자료 둘러보기 →In the first 48-72 hours post-total laryngectomy, the sterile tracheostomy stoma is the only airway. Thick secretions are an immediate threat to airway patency and must be cleared via sterile suctioning as the priority intervention, following the ABC framework.
Assess for signs of airway obstruction: restlessness, tachypnea, decreased SpO2, and audible rhonchi. Pre-oxygenate with 100% FiO2 before suctioning. Limit each suction pass to 10-15 seconds and no more than 3 passes total to prevent hypoxia and mucosal trauma.
Never encourage coughing in a total laryngectomy client; the upper and lower airways are permanently separated, making coughing ineffective. Never use non-sterile technique on a fresh stoma due to the high risk of introducing infection directly into the lungs.
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