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    Nidya Putri
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    Tracheostomy and trachea intubation involve surgical procedures to create an airway through the neck. Tracheostomy involves opening the trachea, while intubation inserts an endotracheal tube through the mouth. Indications for these procedures include respiratory obstruction, retained secretions, and respiratory insufficiency from various conditions. Complications can be immediate like bleeding or pneumothorax, or long-term like stenosis. Ongoing care is needed like suctioning, skin care, tube cleaning and positioning, and humidification. Different tube types exist and decannulation may occur once the underlying condition is resolved and protective airway mechanisms return.

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    15. Tracheostomy

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    Tracheostomy and trachea intubation involve surgical procedures to create an airway through the neck. Tracheostomy involves opening the trachea, while intubation inserts an endotracheal tube through the mouth. Indications for these procedures include respiratory obstruction, retained secretions, and respiratory insufficiency from various conditions. Complications can be immediate like bleeding or pneumothorax, or long-term like stenosis. Ongoing care is needed like suctioning, skin care, tube cleaning and positioning, and humidification. Different tube types exist and decannulation may occur once the underlying condition is resolved and protective airway mechanisms return.

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    1 views40 pages

    Tracheostomy and Trachea Intubation

    Uploaded by

    Nidya Putri
    Tracheostomy and trachea intubation involve surgical procedures to create an airway through the neck. Tracheostomy involves opening the trachea, while intubation inserts an endotracheal tube through the mouth. Indications for these procedures include respiratory obstruction, retained secretions, and respiratory insufficiency from various conditions. Complications can be immediate like bleeding or pneumothorax, or long-term like stenosis. Ongoing care is needed like suctioning, skin care, tube cleaning and positioning, and humidification. Different tube types exist and decannulation may occur once the underlying condition is resolved and protective airway mechanisms return.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 40

    Tracheostomy and Trachea Intubation

    Zeng Quan

    Department of Otolaryngology
    The First Affiliated Hospital
    Chongqing Medical University
    What is“Tracheostomy”

    • Tracheostomy is an operative
    procedure that creates a surgical
    airway in the cervical trachea .
    Anatomical Relations of Trachea

    • Major blood vessels


    (carotis, innominate a.,
    jugular veins)
    • Thyroid gland
    • Esophagus
    • Larynx
    • Nerves (Rec.Laryngeal)
    • Cervical spine
    Tracheostomy
    Relative anatomy
    Tracheostomy Indications

    • Respiratory obstruction
    • Retained secretions
    • Respiratory insufficiency
    Tracheostomy Indications
    Respiratory obstruction

    • Infections
    • Foreign body larynx
    • Trauma
    • Congenital anomalies
    • Tumors
    • Bilateral vocal cord paralysis
    Tracheotomy Indications
    Retained secretions

    • Inability to cough
    • Painful cough
    • Aspiration of pharyngeal
    secretions
    Tracheostomy Indications
    Respiratory insufficiency

    • Chronic lung conditions


    • Conditions listed above
    Types of Tracheostomy

    • Emergency tracheostomy
    • Elective tracheostomy
    • Permanent tracheostomy
    Emergency tracheostomy
    Elective tracheostomy
    Permanent tracheostomy
    Surgical techniques

    • Open procedure
    Position
    Anaesthesia
    Complications
    immediate
    • Apnea
    • Bleeding
    • Pneumothorax or pneumomediastinum
    • Injury to recurrent laryngeal nerves
    • Injury to oesophagus
    • Aspiration of blood
    Complications
    early
    • Early bleeding:
    This is usually the result of increased blood pressure
    as the patient emerges from anesthesia and begins to
    cough.
    • Blocking of tube
    • Tracheitis
    • Tube displacement
    • Subcutaneous emphysema
    • Local wound infection and granulations
    Complications
    late
    • Bleeding
    • Stenosis
    • Tracheoesophageal fistula
    • Tracheocutaneous fistula
    • Scarring
    • Failure to decannulate
    Tracheostomy care
    • Suctioning • Not aggressive and not too much
    deep
    • Skin care • To prevent irritation and
    secondary inflammation due to
    discharge
    • Inner tube
    • Once or more daily remove and
    care
    clean.
    Tracheotomy care
    •
    Tracheostomy care

    • Humidification • “Artificial nose”

    • To prevent decubitus of
    • Tube position
    trachea

    • Not to cover with blanket!


    TYPES OF TRACHEOSTOMY
    TUBES

    • CUFLESS TUBES

    • CUFFED TUBES
    Eating with tracheostomy
    Decanulation
    when?
    • Resolution of pathology that necessitated
    the tracheostomy (upper airway obstruction,
    pneumonia)
    • Normal protective laryngeal mechanisms
    (no aspirations during normal swallowing,
    good coughing)
    • No planed further interventions
    (radiotherapy, H&N operations)
    • No mechanical ventilation
    Trachea Intubation

    This is the most rapid method.

    Larynx is visualised with a larynoscope and


    endotracheal tube inserted.

    This helps to avoid a hurried tracheostomy.


    Cricothyrotomy

    This is a procedure
    for opening the
    airway through the
    cricothyroid
    .membrane
    Thank you

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