Timing of Tracheostomy
Tracheostomy is performed in critically ill adults requiring prolonged invasive ventilation as a strategy to: — reduce respiratory tract injury — improve patient comfort, and/or — to facilitate weaning
Tracheostomy is performed in critically ill adults requiring prolonged invasive ventilation as a strategy to: — reduce respiratory tract injury — improve patient comfort, and/or — to facilitate weaning
fenestrated tracheostomy tube. allows patient to breath normally with a tracheostomy in situ. patient can cough and speak through mouth. improves swallow function. acts a step prior to decannulation
Is this tracheostomy patient ready for decannulation? Hot Case
Ventilator management should be aimed at getting the patient off ventilator support as rapidly as possible. Weaning can be considered once the underlying process necessitating mechanical ventilation is resolving
Tracheostomy is an airway that is inserted subglottically through neck tissues directly into the trachea. Surgical Tracheostomy involves dissection and incision of trachea under direct vision.
Tracheostomy, advantages and disadvantages. Pro: reduced sedation requirement (greater comfort than oro-tracheal intubation). Con: requirement for a surgical procedure with inherent risk of complications
Approach to percutaneous dilatational tracheostomy (PDT) procedure
Summary of evidence for PDT versus open tracheostomy. No difference in ICU or hospital mortality; duration of ventilation; nosocomial pneumonia
Percutaneous tracheostomy = reference to a number of different techniques to insert a tracheostomy (gradual dilation, forceps dilation, rhino and translaryngeal techniques)
There are important considerations regarding tracheostomy management that differ from the standard approach to respiratory distress
Haemorrhage from, or around, a tracheostomy site is both relatively common and potentially life-threatening
LMA is an acronym for Laryngeal Mask Airway; a type of extraglottic airway device aka supraglottic airway device (SAD)