Why and How Tracheostomy done?

-

                         TRACHEOSTOMY

INTRODUCTION:

  • Tracheostomy is making an opening in anterior wall of trachea and covering it into stoma on skin surface
  • Types: 
Emergency tracheostomy,

Elective tracheostomy

Permanent tracheostomy

  • Mid tracheostomy ideal, commonly used through 2nd and 3rd rings behind isthmus
  • Tracheostomy tubes are made of plastic ,soft ,least irritant and disposable 
  • They have inflatable cuff, should be deflated at regular interval to prevent -tracheal necrosis due to pressure





FUNCTIONS:

  • Respiration through alternative pathway in case of obstruction above the stoma
  • Protection of airway from: aspiration of pharyngeal secretion in comatose patient 
  • Blood due to injuries in pharynx ,larynx





INDICATION:

  • RESPIRATORY OBSTRUCTION:

Infection- Ludwig angina,

Peritonsillar infection

Tumor

Trauma to larynx, trachea

  • RETAINED SECRETION:

(Inability to cough)

Comatose patient

Painful cough -trauma to chest

  • RESPIRATORY INSUFFICIENCY:

Chronic lung conditions:

Emphyema

bronchiectasis





TECHNIQUE:

  • Children is intubated prior to surgery 







Position:

  • Supine with neck extended under local or general anesthesia
  • Incision can be vertical (emergency case),transverse (elective case)
  • Veins on the surface ligated -strap muscle separated in midline-thyroid gland retracted upward with blunt hook
  • Trachea exposed -4% xylocaine is infiltrated into trachea 

TRANSVERSE INCISION:

  • Between second and third tracheal ring ,two ends joined with another transverse incision
  • Appropriate size tracheostomy tube is placed ,cuff inflated 
  • Children, vertical or h incision is made





COMPLICATION:

  • EARLY:

Bleeding, wrong placement of tracheostomy tube

  • INTERMEDIATE:

Secondary infection of wound ,blockage of the tube

  • LATE :

Scar 

Tracheal stenosis

CARE :

  • Supervision for bleeding ,breathing difficulty 
  • Suctioning :regularly every half an hourly
  • Deflate cuff every hour for 5 minutes 
  • Cleaning of tracheostomy tube 




Comments

Post a Comment

Popular posts from this blog

Sterilization technique in microbiology

-
Image
HELLO! DOCTOR VANAKAM, I hope you all are doing good today we will be discussing sterilization various methods of sterilization, about dry heat sterilization and moist heat sterilization along with different methods employed, and what are the materials to be placed in this method in detail about autoclave its principle, working and of course uses. As I have had already informed you all through my previous post on the contribution of Louis Pasteur and Koch postulates if we haven't checked it out yet do check it out using this link   https://www.stencildent.com/2020/07/contributions-of-louis-pasteur-and-koch.html  wherein I would explain the importance for the need of the HOUR and always to sterilize things to and from the patients and also get geared up for the next post on SHOCK wherein I would cover the definition, types, classification along with etiology, pathogenesis, flow chart, the complication of septic shock in detail so now without any further ado lets get starte...
Read more

STAGES AND STEPS IN TOOTH PREPARATION

-
Image
                      STAGES AND STEPS IN                                        TOOTH  PREPARATION                 TOOTH PREPARATION INVOLVES 2 STAGES  1) INITIAL TOOTH PREPARATION:    OUTLINE FORM AND INITIAL DEPTH PRIMARY RESISTANCE FORM  PRIMARY RETENTION FORM CONVENIENCE FORM 2) FINAL TOOTH PREPARATION  REMOVAL OF REMAINING CARIES PULP PROTECTION SECONDARY RESISTANCE AND RETENTION FORM FINISHING OF EXTERNAL WALL FINAL PROCEDURE OF CLEANING AND INSPECTING  Each stage and step is explained in detail please refer to above notes . note:please do not  download and share all rights are reserved to stencildent.
Read more

Hypersensitivity microbiology notes

-
Image
                          HYPERSENSITIVITY   hello, doctor vanakam, I hope you all are doing good, as intimated through the last post on anaerobic culture method  https://www.stencildent.com/2020/08/anaerobic-culture-methods-microbiology.html  if u haven't checked it out do read using this link without any further ado lets get started. CONTENTS: 1)Definition 2)Classification 3)type 1 hypersensitivity reaction a)1st exposure b)2nd exposure c)mediators of reaction d)late-phase reaction 4)type 4 hypersensitivity 5)treatment  1)DEFINITION: It refers to a condition in which immune response results in excessive reaction leading to tissue damage, disease, or even death in a sensitised host. 2) CLASSIFICATION: Coomb and gel classification in 1963 into type 1 to 4  Type 1,    type 2, type 3       : They depend on the interaction of antigen with humoral antibodies They are the i...
Read more