Tracheostomy Definition, Indication, Types,procedure, Suctioning,and contraindications ~ Medical diseases and trems ,symptoms causes TREATMENT

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Tracheostomy Definition, Indication, Types,procedure, Suctioning,and contraindications



DEFINITION 

                       A Tracheostomy tube is inserted into the trachea through surgically creating stoma to establish and maintain a patient airway for long period of time. 

INDICATIONS 

Upper airway obstruction due to foreign body ,edema, tumor, stenosis. 

●Respiratory failure.

●Severe head,neck and chest injury.

●Neurological disorder of diaphragm and intercostal muscles.

●Canine biting. 

●Severe extensive burn of face.

●Intolerance of endotracheal tube (10-14 days).

●Any condition in which endotracheal tube can not be inserted. 

CLASSIFICATION 

1. Emergency/Prophylactic .

2. Temporary/ Permanent .

3. High ring (T1-T2)/ Lower ring(T3-T4).

TYPE OF TRACHEOSTOMY TUBES 

1. Double or single lumen cannula tube. 

2. Cuffed and non cuffed.

3. Fenestrated (with talking tube)and non fenestrated tube. 

4. Plastic (silicone and polyvinyl) and metal (stainless steel).

PROCEDURE 

Take consent to patient or family members. 

● Check vitals.

● Patient Npo 6 to 8 hours before procedure. 

● Talk about procedure to patient or family members. 

● First give Rose position to perform procedure. 

● Commonly 2nd and 3rd ring incisored. 

● Place the Tracheostomy tube. 

● After Tracheostomy give Fowler's position. 

SUCTIONING 

              - Suctioning should not be continued more than 5 - 10 seconds.

-Prolonged Suctioning will cause hypoxia and bradycardia (cardiac arrest).

-Hyperoxygenated with 100% Oxygen before Suctioning. 

- Apply Suctioning intermittently while rotating and withdrawing catheter.

Suction Pressure

☆Infant 60-80 mm of Hg.

☆Child 80-100 mm of Hg.

☆Adult 100-120 mm of Hg.

Suction catheter size

☆Infant- 5 to 8 Fr.

☆Child- 8to 10 Fr.

☆Adult- 12 to 18 Fr.

Time

☆First 24 hours Suctioning in every 30 minutes after then Suctioning  every 2 hours. 

Decannulation -The process removal of TT

●Inner cannula should be clean after every 2 to 4 hours with Hydrogen peroxide, Sodium bi-carbonate ,Normal saline.

●Stoma should be clean apply antibiotic ointment and vaseline ghage should be used.

Complication Of Tracheostomy 

☆Tracheomalacia - Tracheal dilation and erosion. 

☆Tracheal stenosis- Narrowing of trachea.

☆Tracheo Esophageal Fistula- Abnormal opening b/w trachea and Esophagus. 

☆Tracheo Innominate Artery Fistula- Abnormal opening b/w trachea and innominate Artery. 

☆Tube obstruction. 

☆Tube dislodgment.





 

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