Soins complexes à domicile pour enfants
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Everyday tips

Bathing and swimming

Always keep the tracheostomy site dry and clean, making sure that no water penetrates the tracheostomy.

Tracheostoma skin care:

  • Clean the skin surrounding the tracheostomy with warm sterile or boiled cooled water.
  • You can used a mild, non-perfumed, non-oily soap (eg, “Dove”), if recommended by your child’s health care team.
  • Never use:
    • perfumed products with additives (they can irritate and damage the skin surrounding the tracheostomy),
    • antibacterial soaps, antiseptics or disinfectants (they decrease the skin’s natural protection barrier against infection),
    • bar soaps (they leave a residue on the skin which may be irritating),
    • baby wipes, baby oil, powder, balm or lotion.
  • Use cotton tips (Q-tips®) or clean compresses dampened with the warm solution recommended by your child’s health care team.

To remove any encrusted secretions stuck  around the tracheostomy site:

  • Clean the skin with a 3% hydrogen peroxide solution diluted half/half with sterile or boiled water.
  • Immediately rinse with a clean compress or cotton tip (Q-tip®) dampened with sterile or boiled water; thoroughly dry the skin.
  • If any redness or bleeding occurs, stop using the hydrogen peroxide solution and consult your child’s health care team.

Bathing:

  • It is much safer to give infants sponge baths.
  • You may bathe older babies in a bathtub using a small amount of water; place a non-slip pad at the bottom of the basin to prevent your child from slipping and water from entering the tracheostomy.
  • Keep a towel close at hand to sponge up any water that may be splashed in and around the neck and tracheostomy.
  • Never leave your child unattended in a bath until your child clearly demonstrates the capacity to reliably keep water from entering his tracheostomy. If water accidentally enters the tracheostomy, suction the tracheostomy immediately to prevent infection.
  • If your child has trouble staying in a seated position, use a non-slip pad or a small bath chair.
  • The use of an artificial nose or a cotton bib can prevent water that is splashed from entering the tracheostomy.
  • Change the cotton ribbons or Velcro® bands, if wet, after the bath.
  • A shower is not recommended except in older children who can take the necessary precautions to prevent water from entering the tracheostomy (ex, direct the water jet away from the neck area, wear a shower tracheostomy protector); discuss options with your child’s health care team.

Washing of the hair:

  • Consider having another adult available to help you with this task, especially if your child is very active.
  • Lay your child down on his back on top of a sink or a hair basin designed for use in a bed.
  • If your child can collaborate, sit him in the bath with his head tilted backwards.
  • Carefully pour water on his head using a small container, making sure to prevent water from entering his tracheal cannula. If water accidentally enters the tracheostomy, suction the tracheostomy immediately to prevent infection.
  • Always rinse the hair with extreme caution.

Mouth care:

  • Your child’s mouth should be cleaned at least twice a day.
  • If your child has no teeth, use a small face cloth or a gauze dampened with water and rolled around your index finger, to gently rub your child’s gums front to back.
  • Once teeth start to appear, brush your child’s teeth after each meal and at bedtime. Since young children have a tendency to swallow toothpaste instead of spitting it out, use only the size of a small grain of rice in children under 2 years old and the size of a small pea in children up to 6 years old. Use this time to also gently massage their gums with the toothbrush.
  • As your child matures, teach and supervise brushing of the teeth.
  • Have your child rinse their mouth with warm water or use a low alcohol content mouthwash if recommended by your child’s health care team
  • Apply, if required, a hydrating lip balm.

Nasal hygiene:

  • In all children, secretions, along with bacteria and viruses collect in the nose. Keeping your child’s nose clean helps prevent lung infections.
  • In infants and children who are unable to blow their noses, saline drops are often used to clean the nose.
  • Refer to your child’s health care team for the technique and the frequency of nasal care recommended for your child, including the procedure for the preparation of homemade saline solution and safe storage.

Swimming:

  • Aquatic sports and swimming are not recommended.

https://complexcareathomeforchildren.com/respiratory-support/tracheostomy-care/everyday-tips/

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A collaboration of clinical experts across Quebec has taken every care to ensure that the information contained in this document is accurate, complete, and reflective of evidence-based practices. However, “Complex care at home for children” collaboration cannot and does not assume any responsibility for application of the content of this document or for any information that may be present in the websites cited as a reference. These web sites are provided for informational purposes only and do not represent the collaboration endorsement of any companies or products. Always consult your child’s physician and/or a qualified healthcare professional to learn more about recommendations specific to your child’s health needs.

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