Objectives

Anatomy.

Causes.

Clinical
Picture.
Management.
Causes of upper airway obstruction:

 Congenital.
 Traumatic.
 Infection.
 Tumors.
 Miscellaneous.
 Bilateral laryngeal nerve palsies.
 Cord fixation due to rheumatoid arthritis.
 Definition of
Tracheostomy

Creation of a surgical opening

into the trachea.
Postoperative care
 Nursing: Full time nursing.
 Position:patient must be sitting upright in
bed.
 Suction.
 Humidification.
 Tracheostomy set beside the patient.
Complications of
Tracheostomy
Immediate:
 Hemorrhage.
 Air embolism.
 Apnea.
 Cardiac arrest.
 Local damage to the:

Thyroid cartilage , Cricoids cartilage and

Recurrent laryngeal nerve.
Intermediate complications
 Dislodgment /displacement of the tube .
 Surgical emphysema of the neck.
 Pneumothorax , pneumomediastinum .
 Scabs & crusts.
 Infection .
 Tracheal stenosis .
 Dysphagia
 Tracheo- esophageal fistula .
Late complications
 Stenosis of the trachea .
 Difficulty with decanulation .
 Tracheo- cutaneous fistula , scars or
granuloma .