Tracheostomy

1. TRACHEOSTOMY
BY
DR.TANIFUL HAQUE
POST GRADUATE TRAINEE
DEPT OF ANESTHESIA,ANALGESIA, AND CRITICAL CARE MEDICINE
RAJSHAHI MEDICAL COLLEGE,RAJSHAHI.

2. TRACHEOSTOMY:
• It provides an airway directly into the
anterior portion of the neck usually at
the level of(2-4) tracheal ring.

3. INDICATION:
• 1.Prophylactic relief of airway obstruction.
• 2.When Prolonged intubation is required.
• 3.To facilitation weaning in ICU.
• 4.To allow suction and removal of secrations.

4. • 5.To protect the tracheobronchial tree
against aspiration
• 6.As a part of complex head and neck
surgery
• 7.Management of severe obstructive sleep
apnoea

6. ADVANTAGE :
• Patient comfort.
• Improve oral hygiene.
• Early weaning.
• Enables speech.
• Access of tracheal toileting.

7. COMPLICATIONS:
1.Early:
• Haemorrhage
• Displacement
• Blockage
• Subcutaneous
emphysema
• Pneumothorax

8. 2.Late:
• Infection
• Tracheal erosion
• Tracheal ulceration
• Tracheal stenosis
• Tracheal dilatation

9. TRACHEOSTOMY CARE:
• Humidification:Reduce risk of obstruction by
viscus secretion
• Tracheobronchial suctioning
• Daily cleaning and dressing
• Secure fixation
• Provision of a means of communication,e.g.pen
and paper

10. CLOSURE OF TRACHEOSTOMY:
• Initial tube is left in situ for at least 72 hours to
allow.
• formation of tract.
• The tube may be changed over a thin catheter
or guide wire.
• Once decannulated,the stoma usually closes
spontaneously.
• within a few days.