Tracheostomy & Laryngectomy Flashcards
What type of trach is this?
Shiley
What is a big question you should ask yourself when you have a patient with a trach?
can I provide PPV ?
What are the parts of a shiley trach? and what part must you have for in order to ventilate?
1) trach (body, cuff, inflation system, flange with tie downs) 2) Introducer 3) inner cannula w/ 15 mm connector (must have this to ventilate)
what is an XLT trach and why is it needed?
insert pic here XLT = extended length tube used when there is excessive distance from the surface of the stoma to the actual trachea
What is the perfusion pressure of the tracheal mucosa?
25 cmH2O (I’ve been told this question was on the boards)
What are the associated intermediate and long term risk of a tracheostomy?
usually occurs in the following order… ischemia necrosis erosion dilation stenosis (due to granulation after removal of the trach apparatus)
Why is Nitrous Oxide a concern with cuffed tracheostomy?
with in 15 min post intubation it can cause the cuff to expand —> lateral wall ischemia development
What type of tracheostomy tube is all metal
Jackson
Note : there is no 15mm connection so you have to use a small ETT connector to bag mask Ventilate
What type of tracheostomy tube is this?
Montgomery T-tube
How would you connect the Montgomery T-tube to the positive pressure ventilation system
Use a ETT connector
How do you control airflow and prevent loss of gas out of the patients airway when they have a Montgomry T tube?
Occlude either the stoma portion of the tube or somehow include the patient’s mouth nasal airway
What type of device is used to maintain stoma patency for future access?
Trach button
What type of treatment equipment is this and what Makes it special?
Kistner trach It allows access for suctioning and also permits speech but cannot use for PPV
What type of trach is referred to as a talking trach
Fenestrated trach
What type of tracheostomy tube is this and what is the gas pathway when the cuff is not inflated?
Fenestrated tracheostomy tube Gas will flow through the inner cannula as well as around the cuff to the vocal cords
In the fenestrated tracheostomy tube, if the inner cannula has been removed and the cap locked on the body with the cuff inflated, Which way will be air flow?
Through the Fenestration and over vocal chords (Producing sound)
What type of trach is this?
Notice the shape of the inner cannula
Communi-trach Used for breathing spontaneously and talking
Name 2 complications associated with tracheostomy tubes
1) Tracheoesophageal fistula 2). Tracheo-innominate artery fistula
Which of the complications of the tracheostomy tube is considered an airway emergency? And how do you treat?
Tracheo-innominate Fistula. Treat temporary by repositioning the tracheostomy tube and Hyper inflating the cuff to tampinade the filstula until the surgery to fix it
What has been put in place to provide a guide to replace the inadvertently removed tracheostomy tube?
Stay sutures
What is the opening in the skin to the trachea referred to as?
Stoma
What is this?
Laryngectomy tube Cannot be used for PPV
If you must replace the tracheostomy tube or laryngectomy tube with and ETT during the procedure what type of ETT should you use?
Anode Allows better positioning of the tube since it can be bent more freely
What adjunct is this?
Trach Coller
Preferred source of oxygen and humidification for the patient that is spontaneously breathing through the tracheostomy tube or Laryngectomy tube
