Tracheostomy a life saving emergency procedure

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A surgical procedure practised in ENT discipline of medical science.

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Tracheostomy a life saving emergency procedure

  1. 1. Dr.Maleka Afroz Associate Professor, ENT USTC, Foy’s Lake Chittagong
  2. 2.    Endotracheal intubation Laryngotomy or Cricothyrodotomy Tracheostomy
  3. 3.        To bypass Airway obstruction (Ca larynx) Tracheobronchial toiletting (Acute laryngotrachealbronchitis,neuroparalysis) Tracheobronchial protection (Unconscious patient) Patient on ventilator ( ICU) Patients with respiratory insufficiency ( COPD) Prior to radical Head- neck or Maxillofacial surgery as a temporary procedure Prior to total laryngectomy as a permanent procedure
  4. 4.    Emergency Elective Permanent
  5. 5. Obstructive –Congenital Acquired-Traumatic Inflammatory Neoplastic F.B. in larynx Paralytic Allergy Non obstructive-Mentioned earlier.
  6. 6.   A little variation is marked in the operative techniques between emergency, elective &permanent procedure. As well as between child & adult tracheostomy.
  7. 7. Steps of Tracheostomy Operation
  8. 8.  Metallic- Outer & inner tube without cuff though reusable.  Portex- Single tube with or without cuff, disposable.
  9. 9.  Care of the tube-Constant supervision for tube blockage or tube displacement, Inner tube, Outer tube, Cuff, Suction clearance, Humidification.   Care of the wound-Regular dressing. Care of the patient- Breathing exercise, Pen & Paper, Bell.
  10. 10.  Immediate- Hemorrhage, Aphonia, Apnoea, Injury to Structures around (apical pleura, nerve, esophagus, cricoid cartilage, fist tracheal ring), surgical emphysema, Tube displacement.  Intermediate- Tube blockage, Chest infection, wound infection.  Late- Layrngeal stenosis, Tracheal stenosis, Tracheo oesophageal fistula, Tracheo cuteneous fistula, Difficult decannulation.

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