tracheostomy

Question 1

tracheostomy

Answer 1

temporary or permanent artificial opening (stoma) made into

the trachea;

Question 2

tracheostomy tube is

inserted to maintain

Answer 2

the patency of the
stoma and the procedure can be performed
either surgically or percutaneously.

Question 3

Percutaneous insertion is performed tracheostomy

Answer 3

A needle is
inserted through the neck into the trachea,
then a guide wire is fed through the needle.
The needle is removed and tract made
bigger by dilators fed over the guide wire.
When the stoma is large enough, the tracheostomy tube is fitted over the guide
wire into the trachea, then the guide wire
is removed and the tracheostomy tube
secured with sutures

Question 4

It is important to know whether a tracheostomy is

Answer 4

temporary (weanable) or permanent (non-weanable),

Question 5

Tracheostomy tubes are either

Answer 5

single or
double cannula (with an outer and inner
cannula).

Question 6

The double cannula allows routine

Answer 6

inspection and clearance of secretions to
prevent blockage of the tube, making it
safer and easier to care for in a ward environment. Patients can be shown how to
remove their own inner tube, and clean
and replace it.

Question 7

An adult female can accommodate a tube

and an adult male .

Answer 7

up to 10mm

up to 11mm

Question 8

if the tracheostomy is too short, there is
a high risk
if it is too long,

Answer 8

of accidental decannulation and
partial obstruction due to poor positioning
; it can rub on or near to the carina, causing ulceration, continuous irritation and coughing

Question 9

Uncuffed tubes

Cuffed tubes are

Answer 9

are used for patients who
can protect their own airway and have an
effective cough, and can clear secretions
independently.
used to
seal the trachea when positive pressure
ventilation is used, and to reduce the risk
of aspiration of secretions in patients who
cannot protect their own airway

Question 10

Cuff-pressure manometer

Answer 10

to assess patency and effectiveness of
cuffed tubes; this hand-held gauge can add
or remove air as necessary

Question 11

Pressure
should be maintained between
and checked?

Answer 11

25-34cmH2O it should be

checked at least twice a day

Question 12

deflation (below 25 cmH2O) m

Answer 12

ay indicate a
problem with the tube and should be
reported, and the tube changed by a competent practitioner if required. Likewise,
overinflation of the cuff can cause tracheal
wall damage and should also be reported
and resolved as soon as possible