Chapter 7 : Tracheotomy

Question 1

Four indications in tracheostomy

Answer 1

SPAM

1. Pulmonary toilet
2. Prolonged Mechanical ventilation
3. Surgical access
4. Airway obstruction

Question 2

Time frame that differentiates early vs late complications

Answer 2

Early < 7 days

Late ≥ 7 days

Question 3

Surgical landmarks in tracheostomy

Answer 3

Hyoid, thyroid, cricoid

Question 4

Difference between tracheotomy vs tracheostomy

Answer 4

Tracheotomy - creation of a stoma in the trachea.

Tracheostomy - creation of a permanent stoma by suturing to the skin.

Question 5

Indications for a vertical incision vs horizontal incision

Answer 5

Vertical incision : emergencies or indistinct landmarks

Horizontal incision : elective, distinct landmarks

Question 6

Normal capillary perfusion pressure of the trachea

Answer 6

25 - 30 mmHg

Question 7

When are cuffed tubes needed?

Answer 7

M-A-P

1) Patients on Mechanical ventilation
2) Aspiration risk
3) Needing Pulmonary toilet

Question 8

Risk factors for tracheocutaneous fistula

Answer 8

B-RaT

1. Bjork flap
2. Radiation therapy

Question 9

Requirements for decannulation

Answer 9

1. Adequate mentation to protect airway
2. No need for further intubation
3. Able to tolerate capping
4. Able to uncap if with difficulty breathing

Question 10

Usual site of bleeding in tracheostomy

Answer 10

Anterior jugular vein injury or bleeding edge of the thyroid