Tracheostomy is a surgical opening of trachea while tracheostomy creation of stoma at the skin surface which leads to the trachea.
it may be used as temporary or permanent, according to the conditions of the patients.
Upper airway obstruction.
Swelling resulting from burns.
To provide broncho pulmonary toileting and to protect the airway.
Conversion of cricothyroidotomy
An alternate pathway of breathing bypass
the upper airway obstruction.
improve the alveolar ventilation.
Laryngomalacia(congenital disease ).
Vocal cord paralysis
acute epiglottis, acute Laryngo-bronchitis, diphtheria.
Bilateral abductor paralysis
Types of according to the uses
Effect of a tracheostomy.
The larynx is bypassed.
There is the risk of respiratory tract infection.
Foreign body reaction can occur causing local inflammation.
Before getting consent from the patients and patients guardians, you must have explained about the precaution, procedure, risk, and complication clearly.
Before the procedure confirms with the ultrasound, whether there is a presence or absence of large blood vessels
Nasogastric feeding should be stopped at least two hours, that may reduce any chance of aspiration of gastric content to the lungs.
Sedation, analgesia drugs, muscle relaxant, and vasoconstriction drugs kept ready before the procedures.
oxygen supply with the appropriate device for delivery with a connector.
keep the suction ready.
Bronchoscope for visualization of the bronchus and carina if needed.
It is done under local anesthesia
Patient in the supine position with neck extended and a wedge keeps a roll under the shoulder.
Before incision of the injection of the 1% lidocaine with 1:20000 epinephrine.
lubricate the tracheostomy tube 2% lignocaine jelly.
A transverse skin incision overlying the upper trachea, that separating the strap muscle of the neck in the midline by retractors
Often thyroid isthmus may displace or divided to allow for adequate exposure of an anterior surface of the trachea.
The tracheostomy tube placed through the second or the third tracheal ring.
keep the suction ready and oxygen by the side.
After incision inserts the tracheotomy tube with the guide wire or an obturator is take out and suction is done when there is a secretion.
Inflate the cuff and check for the position of the tracheostomy tube with an assessment of chest movement, auscultation after confirmation sees the capnography for the confirmation chest, x-ray must be taken when there is extended pneumothorax.
Tracheal trauma (bleeding)
Tracheo-innominate artery damage