Tracheostomy Overview and Types

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Questions and Answers

What is the primary purpose of a tracheostomy?

  • To provide a permanent airway connection
  • To create a temporary stoma for ventilation (correct)
  • To facilitate the administration of anesthesia
  • To remove obstructions from the upper airway

Which type of tracheostomy involves complete removal of the larynx?

  • Permanent tracheostomy (correct)
  • Temporary tracheostomy
  • Percutaneous tracheostomy
  • Open tracheostomy

Which complication is specifically associated with the misplacement of the tracheostomy tube?

  • Tracheal stenosis
  • Pneumothorax
  • Accidental decannulation (correct)
  • Subcutaneous emphysema

What surgical preparation position is typically used for performing a tracheostomy?

<p>Lying supine with a shoulder roll (B)</p> Signup and view all the answers

Which indication for tracheostomy relates to upper airway blockages caused by growths?

<p>Tumours (B)</p> Signup and view all the answers

What is the primary method used to clean a tracheostomy wound?

<p>Irrigation with sterile saline (D)</p> Signup and view all the answers

Which of the following is NOT a type of tracheostomy?

<p>Closed tracheostomy (A)</p> Signup and view all the answers

Which component is essential for tracheostomy care to ensure proper air flow?

<p>Changing/cleaning inner cannula (B)</p> Signup and view all the answers

Flashcards

What is a Tracheostomy?

An opening created surgically in the front of the neck, connecting to the trachea (windpipe).

Difference between temporary & permanent Tracheostomy?

A temporary tracheostomy is an opening made for a limited time, while a permanent one is done for longer, often after larynx removal.

What are some indications for a Tracheostomy?

They help manage airway obstruction from various causes like congenital malformations, trauma, infection, tumors, or vocal cord paralysis.

Describe the main purpose of a Tracheostomy surgery.

The doctor's goal is to open the trachea by creating a window and inserting a tube to maintain an open airway.

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Summarize the surgical technique for Tracheostomy.

It involves a horizontal incision in the neck, separating muscles and the thyroid, then creating a window in the trachea and inserting the tracheostomy tube.

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What is the key goal of Tracheostomy surgery & care?

The main objective is to make a smooth airway passage between the skin opening and the trachea for breathing.

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List some complications that can occur after Tracheostomy.

Bleeding, pneumothorax (collapsed lung), subcutaneous emphysema (air trapped under the skin), tube misplacement, fistula formation, and infection are common complications.

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Explain the importance of Tracheostomy care.

Regular cleaning and replacement of the inner cannula, wound care, suctioning to clear mucus, and humidifying the airway are essential.

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Study Notes

Tracheostomy

  • Tracheostomy is a surgically created opening in the front of the neck into the trachea.
  • It's also the creation of a stoma at the skin surface leading into the trachea.
  • Tracheostomies can be temporary or permanent.
  • Temporary tracheostomies can be elective or emergency.
  • Permanent tracheostomies often follow a laryngectomy, where the larynx is removed and no connection between the upper airway and trachea remains.

Types of Tracheostomies

  • Temporary: Can be elective (planned) or emergency (urgent).

  • Permanent: Usually follows laryngectomy.

  • Open: Surgical incision made in the neck to access the trachea.

  • Percutaneous: Minimally invasive technique.

Indications for Tracheostomy

  • Upper airway obstruction: Congenital, traumatic, or tumorous causes. Infections and vocal cord paralysis also factor.
  • Prolonged ventilation: Patients needing long-term breathing support.
  • Tracheobronchial toilet: Removal of accumulated secretions from the airways.
  • Neurological diseases: Such as following trauma or coma.
  • Head and neck surgery: Preemptive or post-op treatment where airway is compromised.

Surgical Technique

  • The patient is positioned supine with a neck extension.
  • A horizontal incision is made between the cricoid and sternal notch.
  • Strap muscles are divided and retracted; the thyroid isthmus is divided.
  • A window is created in the trachea, and a tracheostomy tube is inserted.

Surgical Technique (Specific steps)

  • Anesthesia is administered.
  • Position the patient for neck extension.
  • Incise the skin and divide the strap muscles.
  • Divide the thyroid isthmus to access trachea.
  • Create a window in the trachea.
  • Insert the tracheostomy tube, securing in place.

Relations (Anatomical structures near the trachea)

  • The trachea is surrounded by critical structures, notably the:
  • Thyroid cartilage
  • Thyroid gland
  • Carotid artery
  • Vagus nerve
  • Recurrent laryngeal nerve,
  • Jugular vein
  • Hyoid bone
  • Superior laryngeal nerve

Complications

  • Bleeding
  • Pneumothorax
  • Subcutaneous emphysema
  • Tube misplacement or displacement
  • Tracheo-esophageal fistula
  • Tracheostomy tube obstruction
  • Accidental decannulation
  • Infection
  • Tracheal Stenosis
  • Tracheocutaneous fistula

Tracheostomy Care

  • Humidification: Maintaining appropriate moisture in the airway.
  • Suctioning: Removing excessive secretions.
  • Wound cleaning: Maintaining the stoma area and tube connections.
  • Changing/cleaning inner cannula: Ensuring the inner part is clean.

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Tracheostomy UMST PDF

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