Tracheostomy

TRACHEOSTOMY

LIDIYAMOL.P.V1ST YEAR M.SC (N)GOVT. CON TCR

DEFINITION - TRACHEOSTOMY

• Tracheostomy is a procedure in which an opening is made into the trachea and an indwelling tube is inserted into the trachea.

• HISTORY • 19th century • In 1869, the German surgeon Friedrich

Trendelenburg reported the first successful elective human tracheotomy to be performed for the purpose of administration of general anesthesia.

INDICATIONS

• 1. To relieve obstruction of the upper air passages caused by: • Impaction of foreign body

• Acute infections such as laryngotracheobronchitis of children, acute epiglottis of influenza or viral origin, laryngeal diphtheria

• Edema of the glottis • Bilateral abductor paralysis of the vocal folds following injury to the recurrent

laryngeal nerves during thyroidectomy • Tumours,particularly carcinoma of the larynx • Chronic stenosis following tuberculosis or scalding • Congenital atresia • severe facial trauma

INDICATIONS:-

• 2. To improve respiratory function • By reducing anatomical dead space, and also

enabling effective respiration of bronchial secretions to be done in

• Fulminating bronchopneumonia • Chronic bronchitis with severe emphysema • Chest injury ,particularly flail chest

INDICATIONS:-

• 3. Respiratoty paralysis • It allows assisted or positive pressure ventilation to be

performed. • Secretions

• Inhaled foreign material due to • Unconsciousness associated with head or faciomaxillary

injuries • Coma from other causes persisting more than a few hours

where there is difficulty in maintaining a free airway • Tetanus

INDICATIONS:-

• 4. As a preliminary to certain operations on the upper airway and surgery involving the head and neck

• 5. In the context of failed orotracheal or nasotracheal intubation

• 6. In the chronic setting, indications for tracheotomy include the

• long- term mechanical ventilation and tracheal toilet, Comatose patients.

ARTICLES NEEDED FOR TRACHEOSTOMY PROCEDURE

• Tracheostomy set containing • Toothed dissecting forceps-1 • Curved mosquito forceps-2 • Straight mosquito forceps-2 • Artery forceps-2 • Allis forceps-2 • Needle holder

• Double hook retractors-2 • Blunt hook • Cricoid hook • Sharp scissors • Tracheal dilator • Cutting edge suture needle with cotton thread • Dressing forceps • Vaseline gauze

• A clean tray containing • Suction catheter with connection • Hand towel • Kidney basin • Scalpel blade-No:11 • Gloves • Mask

• Apron • Antiseptic solution • Local anesthetics (Xylocaine 2%) • Syringes • Needles • Spotlight • Trachesotomy tube

• Suction machine • O2 supply • Ambubag