Tracheotomy Flashcards
What is the difference between a tracheotomy and
tracheostomy?
In its current usage, most practitioners consider them
synonymous.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 190.
When intubation is not possible, what is the quickest
way to obtain an airway in an emergent situation?
Cricothyrotomy
How is a tracheotomy tube secured to a patient’s
skin?
With sutures
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 190.
What type of incision is preferable in young children
undergoing a tracheotomy? Why?
A midline vertical incision. This lessens the likelihood of
stenosis.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 190.
Should patients with symptoms of upper airway
obstruction receive premedication?
No. It is best avoided.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 191.
Describe the three general patient populations that
present for a tracheostomy.
- Patients in which the tracheostomy is a scheduled part of the
procedure, such as a laryngectomy 2. Patients who are
intubated and in critical condition following major trauma or
chronic respiratory failure 3. Patients in which total upper airway
obstruction is present or imminent.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 191.
What are the steps taken if an airway fire develops
during a tracheotomy?
The patient is immediately disconnected from the anesthesia
circuit, normal saline is used to extinguish the fire, the patient is
ventilated with room air from a self-inflating bag.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 193.
What are possible causes of an occluded
tracheostomy tube?
Mucus plug, secretions, blood, the tube is positioned against
the tracheal wall or in the mainstem bronchus.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 193.
Why should an ETT be advanced closer toward the
carina prior to surgical opening of the trachea?
To avoid inadvertent cuff puncture by the surgeon.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 192.
Is full muscle relaxation necessary for a
tracheostomy?
Yes.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 192.
What is the typical health status of a patient
presenting for tracheostomy?
These patients often have cardiac and pulmonary disease, are
debilitated and have metabolic and neurological abnormalites.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 191.
Describe the two most common incisions used for a
tracheotomy.
- A midline vertical incision beginning 1-2 cm inferior to the
cricoid 2. A transverse incision 1-2 cm inferior to the cricoid.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 190.
List the potential postoperative complications of a
tracheostomy.
Hemorrhage, pneumothorax, pneumomediastinum, occlusion or
displacement of the tracheostomy tube.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 193.
