Tracheostomy Flashcards
Exam 1
What is an artificial airway?
An artificial airway is inserted in a patient who may or MAY NOT be breathing on their own. Can be emergent or non-emergent.
What is a tracheostomy tube?
Plastic or metal tube that fits through a stoma in the neck
What do most tracheostomy tubes have?
Outer cannula with an attached flange and cuff with a REMOVABLE inner cannula.
What are some indications for a tracheostomy?
Acute airway obstruction (tumor/swelling), airway protection (after head/neck cancer surgery), facilitate removal of secretions, and prolonged intubation.
Why is a tracheostomy better than prolonged intubation?
Less damage to airway, more comfortable, allowed to eat, mobility is improved (tube more secure)
What are the two types of trachs?
Shiley and Jackson
Describe a Shiley trach.
Has a disposable inner cannula, cuff, and obturator. Is plastic and used short term.
Describe a Jackson trach.
Has a REUSABLE inner cannula, NO CUFF, and an obturator. Metal inner cannula and used long term.
What is an obturator?
Used to insert a trach (think guidewire)
What is the purpose of a cuffed trach (Shiley)?
Helps create a snug fit in trachea to prevent aspiration and help the ventilator give stronger breaths
When are cuffs inflated?
When a patient is mechanically ventilated. The inflation is specifically ordered by physician.
If you should need to deflate the cuff, what should you do?
Suction the oropharynx (mouth) beforehand. Deflate the cuff. Then suction the trachea afterwards.
What are the dangers of prolonged or over-inflation of the cuff?
Increased mucosal pressure, causing ischemia, softening cartilage & mucosal erosion
What can be used in order for a patient to communicate with a trach?
Passy-Muir speaking valve
What should you think about when using a Passy-Muir?
Cuff is DEFLATED when in use, if patient is in any kind of respiratory distress-do not use, must have an OK to use from an MD (usually coordinated with SLP or RT)
