Tracheotomy Flashcards
How many Arteries and Veins supply the Thyroid?
- 2 Arteries (Superior, Inferior)
- 3 Veins (Superior, Middle, Inferior)
What Nerve must be protected when operating around the Thyroid?
Recurrent Laryngeal Nerve (Left and Right)
What is the result of a Recurrent Laryngeal Nerve injury?
- Hoarse Voice
- Noisy Breathing
What is a Tracheostomy?
Surgical procedure to create pathway from Trachea to Skin
What does a Tracheostomy allow for?
- Airway support due to obstruction
- Assisted ventilation
Why would a patient get a Tracheostomy?
- Being intubated for an extended period of time (ET tubes used less than 7 days)
- Cancer patients
What is Patient Positioning for a Tracheostomy?
- Supine with bilateral arms tucked
- Neck extended
- Shoulder roll under scapula
- Head placed in Ring Pillow
- Head of bed tilted down
What are the three specific tools for a Tracheostomy?
- Tracheal Hook
- Tracheal Spreader
- Tube Extension
What are the typical sizes of Trach Tube used?
- 6 (Female)
- 8 (Male)
What is the purpose of the Tube Extension for a Tracheostomy?
Allows Anesthesia access to connect a ventilator
True or False: You don’t need to check the Tracheostomy Tube prior to making an incision.
False
-Check for size and cuff (if needed)
What are the parts of a Tracheostomy Tube?
- Tracheostomy tube
- Cuff
- Balloon
- Inner cannula
- Obturator
Why must the Scrub Tech check the Tracheostomy Balloon prior to making an incision?
- Check for manufacturer defects
- Make sure balloon inflates)
Where is the skin incision made for a Tracheostomy?
Transverse incision midway between Cricoid and Sternal Notch
Why is a vertical skin incision made during emergency Tracheostomies?
To avoid vessels (no time to be careful)
What is done after making the skin incision during a Tracheostomy?
- Dissect the Platysma
- Separate the Sternohyoid muscles
- Divide Thyroid Isthmus
- Expose Trachea
How is the Thyroid Isthmus divided?
Silk suture lower poles and cut up the middle (doesn’t affect Thyroid function)
Where are stay sutures placed and why are they needed?
Prolene used between 3rd and 4th Tracheal Rings to identify opening again if Trach Tube falls out
Where is the Tracheal Incision made?
Centrally along the Third Tracheal Ring
What instrument do you use for a Tracheal Incision?
15 blade (Bovie is a fire hazard)
What is done after making the Tracheal Incision during a Tracheostomy?
- Tracheal Spreader inserted
- Tracheostomy tube inserted
- Obturator removed
- Inner Cannula inserted
- Balloon inflated
- Ventilator attached
How is the Tracheostomy Tube secured?
Flanges are sutured to skin using Nylon suture (Simple Interrupted)
What are the dressings for a Tracheostomy?
- Trach tube tape around neck to help secure tube
- Trach gauze around tube to staunch bleeding
