Scribd Logo
Upload

Welcome to Scribd!

    • 27 views

    Tracheostomy

    Uploaded by

    Jon Asuncion
    This document discusses tracheostomy procedures. It describes tracheostomy as the creation of a stoma in the skin leading to the trachea. There are different types of tracheostomies depending on timing (elective vs emergency), cause (permanent vs temporary), and site (high, mid, low). The procedure may be necessary for conditions that impair oxygen flow like damage to the windpipe, severe pneumonia, heart attack, or stroke. The steps of a tracheostomy procedure are outlined, including patient preparation, needle placement, tube placement, confirmation of proper placement, and securing the tube.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Tracheostomy

    Uploaded by

    Jon Asuncion
    27 views3 pages
    This document discusses tracheostomy procedures. It describes tracheostomy as the creation of a stoma in the skin leading to the trachea. There are different types of tracheostomies depending on timing (elective vs emergency), cause (permanent vs temporary), and site (high, mid, low). The procedure may be necessary for conditions that impair oxygen flow like damage to the windpipe, severe pneumonia, heart attack, or stroke. The steps of a tracheostomy procedure are outlined, including patient preparation, needle placement, tube placement, confirmation of proper placement, and securing the tube.

    Original Title

    tracheostomy

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses tracheostomy procedures. It describes tracheostomy as the creation of a stoma in the skin leading to the trachea. There are different types of tracheostomies depending on timing (elective vs emergency), cause (permanent vs temporary), and site (high, mid, low). The procedure may be necessary for conditions that impair oxygen flow like damage to the windpipe, severe pneumonia, heart attack, or stroke. The steps of a tracheostomy procedure are outlined, including patient preparation, needle placement, tube placement, confirmation of proper placement, and securing the tube.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    27 views3 pages

    Tracheostomy

    Uploaded by

    Jon Asuncion
    This document discusses tracheostomy procedures. It describes tracheostomy as the creation of a stoma in the skin leading to the trachea. There are different types of tracheostomies depending on timing (elective vs emergency), cause (permanent vs temporary), and site (high, mid, low). The procedure may be necessary for conditions that impair oxygen flow like damage to the windpipe, severe pneumonia, heart attack, or stroke. The steps of a tracheostomy procedure are outlined, including patient preparation, needle placement, tube placement, confirmation of proper placement, and securing the tube.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Name: Joseph Ivan S.

    Chung NCM 112 SL Date: 10/13/22


    BSN 3A

    Tracheostomy – creation of stoma at the skin surface which leads the trachea.

    Types of tracheostomy

    Depending on timing

     Elective/ routine
     Emergency

    Depending on cause

     Permanent
     Temporary

    Depending on site

     High
     Mid
     low

    The procedure may sometimes be necessary for people with the following medical conditions, which can
    impair oxygen flow to the lungs:

     damage to the windpipe due to blockages, injuries, or radiation therapy


     severe pneumonia
     massive heart attack
     severe stroke

    Types of tracheostomy technique

    1. Cricothyroidotomy
    2. Open Tracheostomy
    3. Percutaneous Procedure

    PROCEDURE

    1. Preparation for Tracheostomy


    Once the decision to perform a tracheostomy has been made, the surgeon must
    determine if the patient is a good candidate for the surgery and obtain written
    informed consent. In addition, the range of motion of the neck needs to be assessed.
    The tracheostomy team, including the surgeons and anesthesiologists need to discuss
    the entire sequence and alternatives to the procedure. All equipment must be
    available and functioning properly.

    2. Positioning the patient’s neck is extended over a shoulder roll (unless there is a
    contraindication).
    The anesthesiologist stands at the head end of the bed and under direct laryngoscopy
    positions the endotracheal tube (ETT) so that the cuff is midway at the vocal cord
    level.

    3. Positioning
    The patient’s neck is extended over a shoulder roll (unless there is a
    contraindication).
    The anesthesiologist stands at the head end of the bed and under direct laryngoscopy
    positions the endotracheal tube (ETT) so that the cuff is midway at the vocal cord
    level.

    4. Placement of Introducer Needle


    A minimal dissection is performed onto the pretracheal tissue in order to push the
    thyroid isthmus downward.
    The larynx is stabilized and pulled cephalad with the operator’s left hand.
    A bronchoscopy is then performed and the light reflex is used to select the best site
    for the introducer needle.
    Placing the needle at the inferior edge of the light reflex, the tip of the needle is
    directed caudad into the tracheal lumen avoiding the posterior tracheal wall at all
    cost.

    Placement of the Tracheostomy Tube


    5. A tracheostomy tube is loaded onto the dilator
    - Females: a size 6 cuffed Shiley tracheostomy tube is loaded on to the 26 FR dilator
    - Males: a size 8 cuffed Shiley tracheostomy tube is loaded on to the 28 FR dilator

    The dilator is then loaded on the safety ridge of the stylet and placed into the tracheal
    lumen under direct visualization.

    6. Confirmation of Placement 
    The bronchoscope is withdrawn from the ETT and introduced via the tracheostomy
    tube. The placement is confirmed by visualizing the carina.

    7. Securing the Tube


    We routinely secure the tube with 2 sutures of 2-0 nylon on each side of the flange.
    In addition, a tracheostomy tape is used to hold the tube in place. A flexible
    extension tube is used to connect the tube to the ventilator circuit to avoid undue
    movement of the tube in the immediate postoperative period.

    8.
    9.

    10.

    11.

    12.

    13.

    14.

    15.

    16.

    You might also like