Friday, January 10, 2014


Definition : An opening made in the trachea is called tracheostomy.


  • Emergency: choking, stridor
  • Elective: Coma , tetanus, barbiturate,head injuries, pulmonary insufficiency
  • Anaplastic carcinomathyroid patients presenting with stridor due to infiltration of growth into trachea. 
Anaesthesia: LA

  • Incision: Tranverse curved incision 3-4cm at the level of 2nd tracheal ring. 
  • Dissection: Skin , subcutaneous tissue and deep fascia are incised.Isthmus of thyroid is separated.
  • Procedure: A transversed curved cut is made at the level of 2nd tracheal ring, its edge is held by Allis forceps and a small cuff of cartilage is removed. Cricoid hook can be used to stabilise the trachea (found more usefull in children).
  • A suitable sized tracheostomy is introduced within.
  • The cuff of tracheostomy tube is inflated by using 2-5ml of air and is held in place by passing a tape around the neck.
  • Confirm the tube in the trachea not in the subcutaneous plane.
  • Confirm air entry into both lungs.
Post op Rx
  • Suction of tracheostomy tube
  • Regular dressing
  • Humidification of air
  • Check for air entry
Post op complication
  • wound infection
  • Air leakage
  • Improper air entry
  • cricoid stenosis


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