Friday, January 10, 2014

Tracheostomy

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

Indication:

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

Procedure:
  • 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

0 comments:

Post a Comment

Thank You! Do recommend me other medical blogs or website!

 
Copyright (c) 2010 Medik Bloglist !. Design by WPThemes Expert

Blogger Templates and RegistryBooster.