This is the LITFL CCC master page for tracheostomy — follow the links for further discussion of the following:
Pitt Speaking Tube: the facilitation of speaking in the tracheostomized patient; non-fenestrated, cuff tube for continuous mechanical ventilation and airway protection with a port to direct airflow above the cuff to the larynx.
Passy-Muir Valve: facilitation of speech in the tracheostomized patient
Ventilation, summaries of key papers from the ventilation literature: NIV; ARDS; Tracheostomy; Weaning
Tracheostomy complications can be immediate, delayed or late
The presence of a tracheostomy tube can adversely effect swallowing: in patients who previously had no dysphagia; and further impair swallowing function in those who already have neurological or mechanical disorders of swallowing.
To perfrom a tracheostomy, knowledge of the following is required: surface anatomy, course of the trachea, structure of the tracheal rings, layers of dissection, components of the larynx and related structures
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
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