Tracheostomy complications: Difference between revisions
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==Background== | ==Background== | ||
{{Tracheostomy background}} | {{Tracheostomy background}} | ||
==Clinical Features== | |||
==Differential Diagnosis== | |||
{{Tracheostomy DDX}} | |||
==Evaluation== | |||
*Attempt to find out if patient has a tracheostomy vs laryngectomy from history. If the latter is present, the stoma is the only way to ventilate the patient.<ref>https://www.ccam.net.au/handbook/tracheostomy/ Date accessed: 4/24/2018</ref> | |||
==Management<ref>National Tracheostomy Safety Project. Review date 1/4/2014</ref>== | |||
*Call for airway expert help | |||
*Sit patient up or in a position of comfort | *Sit patient up or in a position of comfort | ||
*Place on trach collar oxygen or place | *Place on trach collar oxygen or place non-rebreather mask mask on trachesostmy while preparing | ||
**If any doubt about tracheosomy vs. laryngectomy, be sure to oxygenate nasal/oral airway in addition to stoma | |||
*Don faceshield, have suction, oxygen, flushes (possibly surgical airway supplies) | *Don faceshield, have suction, oxygen, flushes (possibly surgical airway supplies) | ||
*Remove speaking valve or cap (if present) | |||
*Remove inner cannula | |||
*If unable to pass suction catheter at this point, deflate cuff and consider removing tracheostomy tube | |||
== | ==Disposition== | ||
==See Also== | ==See Also== | ||
*[[Medical device complications]] | *[[Medical device complications]] | ||
*[[Surgical airways]] | |||
==External Links== | |||
*[http://www.emdocs.net/trach-travails-need-to-know-ed-tricks-for-airway-emergencies-in-tracheostomy-patients/ emDocs - Need-to-Know ED Tricks for Airway Emergencies in Tracheostomy Patients] | |||
*Justin Morgenstern, "Respiratory distress in the patient with a tracheostomy (update)", First10EM blog, July 25, 2018. Available at: https://first10em.com/tracheostomy/ | |||
==References== | ==References== | ||
<references/> | |||
[[Category:ENT]] | [[Category:ENT]] | ||
[[Category: | [[Category:Surgery]] | ||
[[Category:Pulmonary]] | [[Category:Pulmonary]] | ||
Latest revision as of 19:04, 16 July 2021
Background
Tracheostomy Sizes
- Average size:
- Adult: 5-10mm
- Peds: 2.5-6.5mm
Tracheostomy vs laryngectomy
It is important to differentiate between tracheostomy vs laryngectomy
- If laryngectomy[1]:
- The stoma is the only way to ventilate the patient.
- Patient cannot be orally intubated
Clinical Features
Differential Diagnosis
Tracheostomy complications
Evaluation
- Attempt to find out if patient has a tracheostomy vs laryngectomy from history. If the latter is present, the stoma is the only way to ventilate the patient.[2]
Management[3]
- Call for airway expert help
- Sit patient up or in a position of comfort
- Place on trach collar oxygen or place non-rebreather mask mask on trachesostmy while preparing
- If any doubt about tracheosomy vs. laryngectomy, be sure to oxygenate nasal/oral airway in addition to stoma
- Don faceshield, have suction, oxygen, flushes (possibly surgical airway supplies)
- Remove speaking valve or cap (if present)
- Remove inner cannula
- If unable to pass suction catheter at this point, deflate cuff and consider removing tracheostomy tube
Disposition
See Also
External Links
- emDocs - Need-to-Know ED Tricks for Airway Emergencies in Tracheostomy Patients
- Justin Morgenstern, "Respiratory distress in the patient with a tracheostomy (update)", First10EM blog, July 25, 2018. Available at: https://first10em.com/tracheostomy/
References
- ↑ https://www.ccam.net.au/handbook/tracheostomy/ Date accessed: 4/24/2018
- ↑ https://www.ccam.net.au/handbook/tracheostomy/ Date accessed: 4/24/2018
- ↑ National Tracheostomy Safety Project. Review date 1/4/2014