Tracheostomy complications: Difference between revisions
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==Background== | ==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 | ||
* | *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== | ==See Also== | ||
*[[ | *[[Medical device complications]] | ||
*[[Surgical airways]] | |||
== | ==External Links== | ||
*Justin Morgenstern, "Respiratory distress in the patient with a tracheostomy (update)", First10EM blog, July 25, 2018. Available at: https://first10em.com/tracheostomy/ | |||
==References== | |||
<references/> | |||
[[Category:ENT]] | [[Category:ENT]] | ||
[[Category:Surgery]] | |||
[[Category:Pulmonary]] |
Revision as of 19:35, 8 September 2020
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
- 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