Tracheostomy
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This document summarizes the tracheostomy procedure. It is performed to provide a more secure airway for patients who require prolonged intubation or have upper airway obstruction or neurological disorders requiring a secure airway. The procedure involves making an incision through the neck and trachea to insert a tracheostomy tube. Potential complications include bleeding, infection, tube dislodgement, and injury to nearby structures like the esophagus or recurrent laryngeal nerve. The tube is later downsized or removed once the original indication is resolved and the patient can tolerate capping of the tracheostomy site.
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This document provides information on tracheostomy care including indications, types of tracheostomy tubes, complications, and care of patients with tracheostomies. It describes that a tracheostomy is a surgical opening in the trachea below the larynx used to maintain an airway or enable suctioning. Tube types include plastic vs metal, cuffed vs uncuffed, and single vs double cannula. Complications are discussed as immediate, early, or late issues like hemorrhage, infection, or stenosis. Care involves cleaning the stoma and tube along with suctioning, humidification, and checking cuff pressure as needed.
Tracheostomy care
- A tracheostomy is a surgical opening created in the trachea to allow for breathing assistance or to bypass an obstruction.
- Tracheostomies are performed to provide mechanical ventilation, facilitate weaning from ventilation, bypass obstructions like larynx cancer, maintain an open airway in comatose patients, or remove secretions more easily.
- Tracheostomy care involves examining the tube and site, humidifying air, suctioning secretions, maintaining cuff pressure, changing dressings and tubes, and addressing any complications. Frequent repositioning, deep breathing, coughing and chest physiotherapy also help clear secretions.
Larynx
The document describes the anatomy of the larynx. It covers the development, skeletal framework including cartilages, subdivisions, muscles, histology, blood supply, nerve supply, lymphatic drainage and applied anatomy of the larynx. Key points include the cartilages that make up the skeletal framework, the intrinsic and extrinsic muscles that control movement and phonation, the nerve and blood supply, and common congenital anomalies and pathologies of the larynx.
The diaphragm anatomy & embryology
The diaphragm develops from four sources in the embryo and matures to become a dome-shaped musculofibrous sheet that separates the thoracic and abdominal cavities. It has a central tendon to which muscular fibers attach and is the primary muscle of respiration. During inspiration, it contracts to flatten and lower, increasing the vertical space in the thorax. It has openings that allow structures like the esophagus, inferior vena cava and aorta to pass between the thorax and abdomen. The phrenic nerves provide motor innervation and allow the diaphragm to contract during breathing.
Tracheostomy care and management
This document provides information on tracheostomy care and management. It defines key terms, outlines the indications for tracheostomy placement, potential complications, proper placement according to anatomy, and the steps for tracheostomy care and management. The goal of tracheostomy care is to maintain airway patency, cleanliness, comfort, and prevent displacement. It describes assessing the patient's respiratory status, secretions, and dressing before performing tracheostomy tube suctioning, cleaning, and dressing changes with the aim of removing secretions and maintaining a clean tracheostomy site.
Anaesthesia equipment
Different types of anesthetic equipment and their use. Anaesthetic machine, Cylinders, Breathing systems, Ventilator, Air ways, Laryngoscope, Endotracheal tubes, Tracheostomy tube, I.V.Cannula, Syringe pumps, Magill’s forceps, Central Venous Pressure, Nasogastric tube, ect.
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Tracheostomy is a surgical procedure that creates an opening in the trachea to allow for an artificial airway. It is often needed to bypass airway obstructions caused by tumors, infections, injuries or swelling. Other indications include prolonged intubation, neuromuscular diseases impairing breathing, and as a precaution before certain head and neck surgeries. Care of the tracheostomy tube involves dressing changes, humidification, suctioning, cleaning and monitoring cuff pressure. Complications can include bleeding, pneumothorax, tube obstruction/displacement, tracheomalacia and stenosis. Careful assessment is required before decannulation to ensure airway patency and respiratory function have been restored.
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Tracheostomy is a surgical procedure where an opening is made in the trachea to bypass the upper respiratory tract. It is commonly performed in cases of acute upper airway obstruction or for prolonged ventilation support. There are different types based on duration, site, and circumstances. A temporary tracheostomy may be performed for short term airway management during an emergency or as part of an elective procedure. A permanent tracheostomy disconnects the trachea from the pharynx and is done for procedures involving laryngeal removal. Potential complications can occur immediately, intermediately, or late after the procedure and include hemorrhage, infection, stenosis, fistula formation, and difficulty with decannulation.
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Tracheostomy is a surgical procedure that creates an opening in the trachea to allow direct access to the breathing tube. It has several indications including bypassing upper airway obstruction, removing secretions from the lungs, and facilitating prolonged mechanical ventilation. There are different types of tracheostomies based on location and whether they are temporary or permanent. Potential complications include bleeding, infection, and tracheal stenosis. Proper care including suctioning, humidification, and dressing changes can help prevent complications. Percutaneous dilational tracheostomy is a minimally invasive technique to perform tracheostomy at the bedside using guidewires and dilation. Decannulation involves gradually removing the tracheostomy tube when the original condition improves
ANATOMY OF TRACHEA & TRACHEOSTOMY
Tracheostomy is a surgical procedure that creates an opening in the trachea through the neck. It is commonly performed to bypass upper airway obstructions or to facilitate prolonged mechanical ventilation. Potential indications for tracheostomy include prolonged intubation, neurological impairment putting one at risk for aspiration, and obstructive sleep apnea. Complications can include bleeding, infection, tube dislodgement, and tracheal stenosis. Care of the tracheostomy involves tube changes, suctioning, humidification, and assessing readiness for decannulation.
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This document discusses laryngeal trauma, including anatomy, mechanisms of injury, diagnosis, evaluation, classification, and management. It covers various types of laryngeal injuries such as blunt trauma, penetrating trauma, fractures, and caustic or thermal injuries. Management is based on the Fuhrman classification and involves supportive care, endoscopic examination, tracheostomy, or surgical repair depending on the severity of injury. The goal is to secure the airway and properly treat any fractures, lacerations, exposed cartilage, or other structural damage to the larynx.
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It is a surgical opening in the anterior wall of the trachea just below the larynx. Or is an operative procedure that creates a surgical airway in the cervical trachea.A tracheostomy may be performed
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Tracheostomy final
The document discusses tracheostomy, including its history, types, techniques, and indications. Some key points:
- Tracheostomy involves making an opening in the trachea and bringing it out through the skin, bypassing the larynx. It dates back to ancient Egypt but was further developed in the 15th-20th centuries.
- It can be temporary or permanent, and is classified by location (high, mid, low). Common techniques are open surgical and percutaneous tracheostomy.
- Indications include upper airway obstruction, removing secretions, prolonged ventilation, and as part of other procedures like laryngectomy. Percutaneous tracheostomy is now common in intensive care.
Tracheostomy Final.pptx
This document provides information about tracheostomy including:
- A brief history and current uses of the procedure
- Indications and contraindications
- Anatomy of the trachea
- Surgical steps for performing an open tracheostomy
- Types of tracheostomy tubes and their uses
- Post-operative care considerations
The document serves as an educational guide for performing tracheostomies and tracheostomy tube selection and management.
Microlaryngeal surgery
1. The document discusses tracheostomy and anaesthesia considerations for microlaryngeal surgery. It covers the definition, history, steps of the procedure, complications, types of tubes, and techniques for airway management including endotracheal intubation and jet ventilation.
2. Lasers are commonly used in microlaryngeal surgery and ENT procedures. Safety precautions are required due to the risks of burns, fires and smoke inhalation. Special endotracheal tubes coated in metal foil or other fire-resistant materials help protect the airway during laser use.
3. Careful planning is needed for airway management and ventilation during these delicate procedures to provide optimal surgical conditions while protecting the patient's air
Pcdt
1. The document compares the surgical and percutaneous dilational tracheostomy (PCDT) procedures for creating a tracheostomy from 2013-2015.
2. 51 total cases were performed, with 2 patients requiring conversion to an open procedure due to bleeding complications with PCDT.
3. PCDT was found to be a safe and effective alternative to the open surgical procedure with comparable late complications but lower early bleeding risks and cost.
18. tracheostomy kk
Here are the key anatomical considerations between pediatric and adult tracheostomy:
- The pediatric trachea is smaller in diameter and more anterior in position compared to adults. This makes the surgical procedure more challenging in children.
- The subglottic region in children is relatively narrower compared to adults. This predisposes them to develop subglottic stenosis more easily if the tracheostomy is performed too high.
- The tracheal cartilage rings are more flexible in children compared to adults. This makes the pediatric tracheal wall more prone to collapse and deformity with long-term intubation or tracheostomy.
- Decannulation is more difficult in children because their larynx is positioned higher in the neck
18. tracheostomy kk
Here are the key anatomical considerations between pediatric and adult tracheostomy:
- The pediatric trachea is shorter, more vertical and closer to the skin surface compared to adults. This makes pediatric tracheostomy more prone to complications like surgical emphysema.
- The subglottic region in children is narrower and more prone to stenosis on irritation or injury.
Decannulation is more difficult in children because:
- Their larynx is higher in the neck which makes tolerance of an artificial airway removal challenging.
- The larynx and trachea are still developing in children. Long-term intubation can impair this development, resulting in incoordination of laryngeal reflexes and inability to tolerate
Trachy
A tracheostomy involves surgically creating an opening in the trachea to allow for breathing. It can be temporary, permanent, or done in an emergency. Indications include airway obstruction, clearance of secretions, long-term intubation, and electively for surgery or radiation treatment. Risks include bleeding, respiratory problems, and infections. Complications can be early like accidental tube displacement or late like infection, skin breakdown, or tracheal stenosis. Tracheostomy tubes have parts like the outer cannula, cuff, and flange. Nursing care focuses on dressing changes, suctioning, humidification, and assessing for complications.
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Tracheostomy
- 1. Tracheostomy Dr. John McCormick-Deaton, DO General Surgery PGY-2
- 2. Purpose/Description • Elective procedure • Provides a more secure airway • Improves Pt comfort • Improves Oral Hygiene • Increases Pt mobility • Enhances secretion removal
- 3. Indications • Prolonged intubation • Need for secure airway in Maxillofacial injury • Upper Airway obstruction • Need for secure airway in Neurological disorders
- 4. Complications • Bleeding • Wound Infection • Tube dislodgement/malposition • Pneumothorax, pneumomediastinum, SubQ emphysema • Esophageal perforation • Tracheal malacia • Tracheal Stenosis • Fistulas: tracheoesophageal, tracheoinnominate artery (TIAF) – Occurs Rarely (~0.3%) – 50-80% mortality rate • RLN Injury
- 5. Downsize • Large caliber, non-fenestrated, cuffed tube to Small caliber, fenestrated uncuffed tube. – Allows for normal speech • Intermittent finger occlusion • Passy-Muir valve – Facilitates stoma closure
- 6. Removal • Original indication for tracheostomy resolved • Tolerate capping >24hrs • If upper airway mass or tissue reconstruction was original indication; pre-decanulation flexible laryngoscopic exam recommended.
- 7. Landmarks
- 8. Anatomy
- 9. Anatomy • ~11.8 cm Long • 18-22 cartilaginous rings • Blood supply – Inferior thyroid – Internal thoracic – Supreme intercostal – Bronchial arteries • Begins ~1.5cm below the Vocal Cords • ~50% of the trachea is cervical w/ hyperextension
- 10. Procedure • Vertical or Horizontal incision made over the 2nd or 3rd tracheal rings. – Carried through the platysmas • Blunt dissection of Strap Muscles • Gently retract Thyroid/Isthmus – retracted cranially – May need to divide
- 11. Procedure • Stay sutures placed laterally to ostomy incision site – Can be used as traction – Landmark if dislodgement occurs • Midline trachea incised at 2nd and 3rd ring – Must preserve 1st tracheal ring – Do not puncture ETT cuff • ETT deflated and withdrawn proximal to ostomy site by Anesthesia
- 12. Procedure • Tracheal spreader to gently enlarge ostomy and accommodate trach • Remove inner cannula and attach to vent to ensure proper placement • Remove ETT • Close w/ simple skin sutures • Flange is secured w/ sutures and tied around neck
- 14. Procedure • <iframe width="640" height="480" src="http://www.youtube.com/embed/d_5eK kwnIRs?rel=0" frameborder="0" allowfullscreen></iframe>