護理師為病人進行氣切套管護理，哪項措施最能預防感染？
A nurse is performing tracheostomy care for a client. Which action is most important to prevent infection?
- AApplying a new sterile dressing.更換新的無菌敷料
- BUsing sterile technique when changing the inner cannula and performing suctioning.✓ 正解在更換內套管及抽吸時使用無菌技術
- CEnsuring the tracheostomy tube is securely tied.確保氣切套管固定牢固
- DSuctioning secretions every 2 hours.每 2 小時抽吸分泌物
氣切套管（tracheostomy tube）的護理是為了維持呼吸道通暢並預防感染。氣切造口直接連接至氣管，是病原體進入下呼吸道的潛在途徑。因此，在執行任何可能污染或接觸到氣切管腔的護理操作時，必須遵循嚴格的無菌技術（sterile technique）。正確答案 B 指出「使用無菌技術更換內管並進行抽痰」，這是最能預防深層呼吸道感染（如肺炎）的措施。抽痰（suctioning）和更換內管（inner cannula）都屬於侵入性操作，若非無菌，極易將皮膚或環境中的病原體帶入氣管和肺部。選項 D（定時抽痰）是必要措施，但若無菌技術不足，反而會增加感染風險。選項 A（更換敷料）和 C（固定氣切管）也是重要護理，但相較於直接接觸管腔的無菌操作，其預防感染的重要性稍低。
Tracheostomy care aims to maintain airway patency and prevent infection. The tracheostomy stoma directly connects to the trachea, creating a potential route for pathogens into the lower airway. Therefore, strict sterile technique must be followed during any procedure that may contact the tube lumen. Option B is correct because using sterile technique when changing the inner cannula and suctioning best prevents deep respiratory infections such as pneumonia. Both suctioning and inner cannula changes are invasive procedures; without sterile technique, skin or environmental pathogens can easily enter the airway and lungs.
無顯著差異。氣切套管的照護原則，包括無菌技術的應用，在台灣與美國的醫療實務中是一致的。兩地都會強調在進行抽痰、更換內管等侵入性操作時，必須嚴格遵守無菌原則，以預防吸入性肺炎等併發症。