Tracheostomy Flashcards
What is the treatment of upper airway obstruction expected to resolve with appropriate tx?
Temporary tracheostomy
What are diseases where a temporary tracheostomy is indicated?
Brachycephalic airway disease
Laryngeal paralysis
Mass causing obstruction
Oropharyngeal or laryngeal trauma
It is preferred that a patient is sedated for a temporary tracheostomy?
INTUBATED and ANESTHETIZED
T/F: You want the smallest size tube that can be easily accommodated by the trachea?
Largest size tube- sizes don’t correspond to ET tube
What position should a patient be placed?
Dorsal recumbency w/ neck placed over rolled towel
What is the landmark for your incision?
caudal edge of cricoid (4-5 cm in length)
What are you dissecting in between and what instrument can be used to help you better visualize the area?
Strap muscles
Gelpi retractors aid in visualization
What type of incision is made in the trachea and in what rings?
Transverse interannular incision
between 3rd and 4th or 4th and 5th
What percentage of the trachea can be incised?
No more than 50%
What can be used for manipulating the trachea when changing tubes?
Stay sutures
How often should you be checking on your temporary trach patient?
Q4hr care w/ continuous monitoring
What can the tracheostomy site be cleaned with?
0.05% chlorhexidine
How long should you pre-oxygenate your patient for?
3-5 minutes
How often should the tube be replaced?
Q24 hrs.
What are some complications?
Tube occlusion Airway suctioning Vagally mediated bradycardia and collapse Pneumomediastinum Sx site infection Coughing, gagging, vomiting Aspiration pneumonia
