Tracheostomy is a surgical procedure where surgeons create a direct airway passage with an incision in trachea.
The trachea joints with upper airway and lungs, which provide moist warm air and eliminate CO2.
This procedure is performed in following situations of patient:
Struggling with ventilator withdrawal
Experiencing trauma
Suffering with a severe neurological injury
Indications
Tracheostomy is indicated for severe facial trauma, burns, swelling, tumors, which causes airway obstruction.
Patients who need long-term ventilation should undergo tracheostomy in intensive care unit.
Tracheostomy is used as long-term mechanical ventilation in respiratory failure for chronic cough.
Tracheostomy is performed in patients with neurological conditions which damage their swallowing and affects airway protection.
Contraindications
Exact contraindications are not available for tracheostomy.
Temporary tracheostomy may be performed below the first tracheal ring.
Outcomes
It is performed as bedside procedure, thus it reduces the expenses for transportation and arrangement of operation room.
Tracheostomy in ventilated patients may decrease sedation, which enhances comfort and mobility.
It is used for site survey to prevent complications from direct injury.
Equipment required
It is performed as bedside procedure, thus it reduces the expenses for transportation and arrangement of operation room.
Tracheostomy in ventilated patients may decrease sedation, which enhances comfort and mobility.
It is used for site survey to prevent complications from direct injury.
Patient Preparation
Patient Positioning:
Assist the patient to lay down in a supine position with their neck should be straight and give support from backside.
Fig. Tracheostomy
Technique
Step 1: Anesthesia and Sedation
Give local or general anesthesia as required.
 Step 2: Identification of incision site
Surgeons should finalize the incision site as cricoid cartilage and second and third tracheal rings.
Step 3: Perform the incision
Surgeons will perform a horizontal or vertical incision through the skin, between the cricoid cartilage and the sternal notch.
Step 4: Tracheal entry
Surgeons create an opening in the tracheal region and give a cut through cricothyroid membrane and first tracheal ring.
Place tracheostomy tube correctly within the trachea opening.
Step 5: Tube Securement and Closure
The tracheostomy tube is secured by surgeon and then skin incision is closed with the help of absorbable sutures.
The two types of tracheostomies as follows:
In open tracheostomy procedure, surgeons create a direct opening into the trachea to ensure a safe airway.
In percutaneous tracheostomy, it also creates a tracheal opening for airway access but without any formal incision it was performed as bedside procedure.
Complications
Bleeding can occur in between or post-operation due to injury to neck or tracheal mucosa blood vessels.
Post surgery may cause surgical site infections, cellulitis, deep neck infections, and systemic symptoms.
Tracheal wall injury during tracheostomy may cause stenosis and fistula complications.
Tracheostomy sites may form granulation tissue over time, which cause stoma stenosis.
Tracheostomy is a surgical procedure where surgeons create a direct airway passage with an incision in trachea.
The trachea joints with upper airway and lungs, which provide moist warm air and eliminate CO2.
This procedure is performed in following situations of patient:
Struggling with ventilator withdrawal
Experiencing trauma
Suffering with a severe neurological injury
Tracheostomy is indicated for severe facial trauma, burns, swelling, tumors, which causes airway obstruction.
Patients who need long-term ventilation should undergo tracheostomy in intensive care unit.
Tracheostomy is used as long-term mechanical ventilation in respiratory failure for chronic cough.
Tracheostomy is performed in patients with neurological conditions which damage their swallowing and affects airway protection.
Exact contraindications are not available for tracheostomy.
Temporary tracheostomy may be performed below the first tracheal ring.
It is performed as bedside procedure, thus it reduces the expenses for transportation and arrangement of operation room.
Tracheostomy in ventilated patients may decrease sedation, which enhances comfort and mobility.
It is used for site survey to prevent complications from direct injury.
It is performed as bedside procedure, thus it reduces the expenses for transportation and arrangement of operation room.
Tracheostomy in ventilated patients may decrease sedation, which enhances comfort and mobility.
It is used for site survey to prevent complications from direct injury.
Patient Positioning:
Assist the patient to lay down in a supine position with their neck should be straight and give support from backside.
Fig. Tracheostomy
Step 1: Anesthesia and Sedation
Give local or general anesthesia as required.
 Step 2: Identification of incision site
Surgeons should finalize the incision site as cricoid cartilage and second and third tracheal rings.
Step 3: Perform the incision
Surgeons will perform a horizontal or vertical incision through the skin, between the cricoid cartilage and the sternal notch.
Step 4: Tracheal entry
Surgeons create an opening in the tracheal region and give a cut through cricothyroid membrane and first tracheal ring.
Place tracheostomy tube correctly within the trachea opening.
Step 5: Tube Securement and Closure
The tracheostomy tube is secured by surgeon and then skin incision is closed with the help of absorbable sutures.
The two types of tracheostomies as follows:
In open tracheostomy procedure, surgeons create a direct opening into the trachea to ensure a safe airway.
In percutaneous tracheostomy, it also creates a tracheal opening for airway access but without any formal incision it was performed as bedside procedure.
Bleeding can occur in between or post-operation due to injury to neck or tracheal mucosa blood vessels.
Post surgery may cause surgical site infections, cellulitis, deep neck infections, and systemic symptoms.
Tracheal wall injury during tracheostomy may cause stenosis and fistula complications.
Tracheostomy sites may form granulation tissue over time, which cause stoma stenosis.
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