5.1 Tracheostomy Flashcards
What is the first step of the respiration system?
Ventilation: Movement of air into and out of respiratory passage and lungs
What is the second step of the respiration system?
Gas exchange between air in the lungs and blood
What is the third step of the respiration system?
Transport of O2 and CO2 in the blood
What is the fourth step of the respiration system?
Gas exchange between the blood and tissues
What is tracheostomy?
Surgery to create opening in trachea through the neck
What is a tracheostomy tube?
A 2-3” long curved tube placed in stoma (hole at base of neck)
What are the two types of tracheostomy tubes?
Can be cuffed or uncuffed
What are the different reasons why someone would get a tracheostomy tube? (10)
- Tumors
- Laryngectomy
- Subglottic stenosis
- Subglottic web
- Tracheomalcia
- Vocal fold paralysis
- Injury to larynx or mouth
- Obstructive sleep apnea
- Burns
- Neuromuscular diseases (effecting diaphragm)
What are the two most common reasons for a pediatric trach?
- Genetic (syndrome)
- Accidents
What are the differences between pediatric pharynx anatomy and adult pharynx anatomy? (4)
- Smaller airway, more easily obstructed
- More soft tissue (more likely to have edema)
- Airway more prone to spasms
- Less cartilage support, more prone to collapse
What are the advantages of an endotracheal tube?
What are the disadvantages? (3)
- No surgery, quick/easy
- May damage vocal folds
- Typically less tolerated by patient
- Limits oral experiences with communication and eating
What are the advantages of a tracheostomy tube? (5)
What are the disadvantages?
- Many benefits (see above)
- Easier to manage secretions around vocal tract
- Easier to wean from mechanical breathing with trach
- More comfortable than intubation
- More options for oral communication and feeding
- Surgery
Slide nine
Identify the parts in the picture
- 15mm adapter or oral end
- Balloon and cuff secure airway
- Flange at proximal end to secure oral end to present from entering oral cavity
What is the outer cannula of the tracheostomy tube?
Outside wall of trach, remains in place to keep airway open
What is the inner cannula of the tracheostomy tube?
Fits inside outer, comes out easily for cleaning, can be disposable
What is the flange of the tracheostomy tube?
Secures trachea to neck, ties to go around neck
What is the obturator of the tracheostomy tube?
Used only during insertion process and removed after that
What is the button of the tracheostomy tube (plug, cap, or cork)?
Have to first remove inner cannual and used only with cuffless trach
What is the cuff of the tracheostomy tube?
What does it do?
Balloon that surrounds the outer cannula
Prevents air from escaping around tube from lower to upper airway
Cuffed tube can be ____________ or not
fenestrated
What is a fenestrated tube? (2)
A fenestrated tracheostomy tube in situ.
Airflow passes through the single fenestration
A tracheostomy tube can have a __________ or ___________ fenestrations?
Single
Multiple
Placement of a what blocks the fenestration?
Nonfenestrated inner cannula blocks the fenestration
What are the different types of tracheostomy? (6)
- Temporary
- Permanent
- Emergency
- Percutaneous
- Minitracheostomy
- Cricothyroidotomy
What are the indications that someone would need a tracheostomy? (5)
- To provide and maintain a patent airway
- To enable the removal of tracheobronchial secretions
- To permit long term positive pressure ventilation
- To improve patient comfort
- To decrease the work of breathing and increase volume of air entering the lungs
What are the components of a tracheostomy tube? (6)
- Size ranges from 2.5mm-11mm
- Curved tube
- Inflatable cuff (optional)
- Flanges with holes
- Fenestrated (optional)
- Tube bladder
What are the basic three steps of surgery for a tracheostomy?
- Surgical cuts in the tracheal rings
- Creates tracheal opening
- Inserts tracheostomy tube
