Tracheotomy





W Tracheotomy




1. Introduction
    Tracheotomy is an incision into the trachea to form a temporary or permanent opening, the latter of which is called a tracheostomy. The incision is made through the second, third, or fourth tracheal ring, and a tube is inserted through the opening to allow passage of air and the removal of tracheobronchial secretions. Except in cases of head, neck, and face trauma, tracheotomy is rarely performed as an emergency procedure.

a) Indications for tracheostomy
(1) To relieve upper airway obstruction

(a) Foreign body

(b) Trauma

(c) Acute infection: acute epiglottitis, diphtheria

(d) Glottic edema

(e) Bilateral abductor paralysis of the vocal cords

(f) Tumors of the larynx

(g) Congenital web or atresia

(2) To improve respiratory function
(a) Fulminating bronchopneumonia

(b) Chronic bronchitis and emphysema

(c) Chest injury with or without flail chest

(3) Respiratory paralysis
(a) Unconscious head injury

(b) Bulbar poliomyelitis

(c) Tetanus

(d) Prolonged intubation

b) Tracheostomy technique
(1) Patient positioned supine with sandbag between scapulae

(2) Transverse cervical skin incision 1 cm above the sternal notch

(3) Incision extending to the sternocleidomastoid muscles

(4) Dissection through fascial planes and retraction of anterior jugular veins

(5) Retraction of the strap muscles

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Dec 2, 2016 | Posted by in ANESTHESIA | Comments Off on Tracheotomy

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