Tracheostomy complications: Difference between revisions

Revision as of 11:55, 20 July 2015

(1) Thyroid cartilage (2) Cricothyroid ligament (3) Cricoid cartilage (4) Trachea (A) Cricothyrotomy site (B) Tracheotomy site

Tracheotomy in situ
1 – Vocal folds
2 – Thyroid cartilage
3 – Cricoid cartilage
4 – Tracheal rings
5 – Balloon cuff

Shiley™ trach tube

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

Authors:

@@ Line 8: / Line 8: @@
 ==Diagnosis==
-===Bleeding===
-*Local Bleeding
-**Use silver nitrate if bleeding source is identified
-*Brisk Bleeding
-**Tracheoinnominate artery fistula until proven otherwise
-***Most pts present within first 3wk after tracheostomy
-***Treatment:
-****1. Hyperinflate the cuff (85% successful)
-****2. If above fails, withdraw tube while placing pressure against anterior trachea
-*****Apply digital pressure of innominate artery against the manubrium
-****3. If above fails, place a cuffed ET tube to prevent pulmonary aspiration of blood
 ==Management==