TRAQUEOTOMIA PDF

Figure B shows an external view of a patient who has a tracheostomy. Some sources offer different definitions of the above terms. Part of the ambiguity is due to the uncertainty of the intended permanence of the stoma hole at the time it is created. Emergency airway access 2. Airway access for prolonged mechanical ventilation 3.

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Tracheostomy Open pop-up dialog box Close Tracheostomy Tracheostomy A tracheostomy is a surgically created hole stoma in your windpipe trachea that provides an alternative airway for breathing.

A tracheostomy tube is inserted through the hole and secured in place with a strap around your neck. Tracheostomy tray-key-OS-tuh-me is a hole that surgeons make through the front of the neck and into the windpipe trachea.

A tracheostomy tube is placed into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy. A tracheostomy provides an air passage to help you breathe when the usual route for breathing is somehow blocked or reduced.

A tracheostomy is often needed when health problems require long-term use of a machine ventilator to help you breathe. In rare cases, an emergency tracheotomy is performed when the airway is suddenly blocked, such as after a traumatic injury to the face or neck.

For some people, a tracheostomy is permanent. Emergency tracheotomies are difficult to perform and have an increased risk of complications. A related and somewhat less risky procedure used in emergency care is a cricothyrotomy kry-koe-thie-ROT-uh-me.

Request an Appointment at Mayo Clinic Risks Tracheostomies are generally safe, but they do have risks. Some complications are particularly likely during or shortly after surgery. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure. Immediate complications include: Damage to the trachea, thyroid gland or nerves in the neck Misplacement or displacement of the tracheostomy tube Air trapped in tissue under the skin of the neck subcutaneous emphysema , which can cause breathing problems and damage to the trachea or food pipe esophagus Buildup of air between the chest wall and lungs pneumothorax , which causes pain, breathing problems or lung collapse A collection of blood hematoma , which may form in the neck and compress the trachea, causing breathing problems Long-term complications are more likely the longer a tracheostomy is in place.

You may also be asked to stop certain medications. A local anesthetic to numb the neck and throat is used if the surgeon is worried about the airway being compromised from general anesthesia or if the procedure is being done in a hospital room rather than an operating room. The type of procedure you undergo depends on why you need a tracheostomy and whether the procedure was planned.

There are essentially two options: Surgical tracheotomy can be performed in an operating room or in a hospital room. The surgeon usually makes a horizontal incision through the skin at the lower part of the front of your neck.

The surrounding muscles are carefully pulled back and a small portion of the thyroid gland is cut, exposing the windpipe trachea. At a specific spot on your windpipe near the base of your neck, the surgeon creates a tracheostomy hole.

Minimally invasive tracheotomy percutaneous tracheotomy is typically performed in a hospital room. The doctor makes a small incision near the base of the front of the neck. A special lens is fed through the mouth so that the surgeon can view the inside of the throat. Using this view of the throat, the surgeon guides a needle into the windpipe to create the tracheostomy hole, then expands it to the appropriate size for the tube.

For both procedures, the surgeon inserts a tracheostomy tube into the hole. A neck strap attached to the face plate of the tube keeps it from slipping out of the hole, and temporary sutures can be used to secure the faceplate to the skin of your neck.

A nurse will teach you how to clean and change your tracheostomy tube to help prevent infection and reduce the risk of complications. Generally, a tracheostomy prevents speaking because exhaled air goes out the tracheostomy opening rather than up through your voice box. But there are devices and techniques for redirecting airflow enough to produce speech.

Depending on the type of tube, width of your trachea and condition of your voice box, you may be able to speak with the tube in place. If necessary, a speech therapist or a nurse trained in tracheostomy care can suggest options for communicating and help you learn to use your voice again.

Coping with dry air. The air you breathe will be much drier because it no longer passes through your moist nose and throat before reaching your lungs. This can cause irritation, coughing and excess mucus coming out of the tracheostomy. Putting small amounts of saline directly into the tracheostomy tube, as directed, may help loosen secretions. Or a saline nebulizer treatment may help. A device called a heat and moisture exchanger captures moisture from the air you exhale and humidifies the air you inhale.

A humidifier or vaporizer adds moisture to the air in a room. Managing other effects. Your health care team will show you ways to care for other common effects related to having a tracheostomy.

For example, you may learn to use a suction machine to help you clear secretions from your throat or airway. Results In most cases, a tracheostomy is temporary, providing an alternative breathing route until other medical issues are resolved. If you need to remain connected to a ventilator indefinitely, the tracheostomy is often the best permanent solution.

The hole may close and heal on its own, or it can be closed surgically.

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