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Topic: Tracheostomy

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	Tracheotomy - Wikipedia, the free encyclopedia
		A tracheotomy or tracheostomy is a surgical procedure performed on the neck to open a direct airway through an incision in the trachea (the windpipe).
		In emergent settings, in the context of failed endotracheal intubation or where intubation is contraindicated, cricothyrodotomy or mini-tracheostomy may be performed in preference to a tracheostomy.
		Insert tracheostomy tube (with concomitant withdrawal of endotracheal tube), inflate cuff, secure with tape around neck or stay sutures.
	en.wikipedia.org /wiki/Tracheostomy (366 words)

	Tracheostomy - PetPlace.com
		Tracheostomy is a surgical procedure in which a new opening is created into the trachea or wind pipe to facilitate the passage of air or the evacuation of secretions.
		A permanent tracheostomy is used in cases of severe upper airway obstruction that cannot be treated medically or surgically, such as collapse of the larynx or tumors of the larynx that cannot be removed surgically.
		Remember that the tracheostomy is often only a symptomatic treatment to allow your pet to breathe easier; the primary problem is usually still present and may continue to progress and cause further difficulty for your pet.
	www.petplace.com /articles/artShow.asp?artID=640 (702 words)

	Tracheostomy
		A tracheostomy is a surgical procedure to cut an opening into the trachea (windpipe) so that a tube can be inserted into the opening to assist breathing.
		Tracheostomy may be performed as an emergency procedure to provide relief of blockage of airways above the trachea.
		A non-emergency tracheostomy may be performed for a variety of reasons: for example, before surgery to the throat or mouth so the patient can breathe after the surgery or to make the prolonged use of ventilators more comfortable and safe.
	www.betterhealth.vic.gov.au /bhcv2/bhcarticles.nsf/pages/Tracheostomy?open (1038 words)

	Tracheostomy: Postoperative Recovery (Site not responding. Last check: 2007-10-22)
		Tracheostomy tubes may be inserted following oropharyngeal or prolonged intubation, when needed for mechanical ventilation, obstructive sleep apnea resistant to conventional therapy, and upper airway bleeding.
		A tracheostomy tube may be accidentally dislodged by excessive manipulation or suctioning, which may produce vigorous coughing that displaces the tube from the stoma.
		Tracheostomy ties should be taut enough to prevent accidental dislodgement but loose enough to avoid choking or pressure on the jugular veins.
	www.perspectivesinnursing.org /v1n1/Dixon.html (1896 words)

	World Anaesthesia Issue 15 (Site not responding. Last check: 2007-10-22)
		Tracheostomy is a common surgical procedure performed on critically ill intensive care patients.
		Infection rates for percutaneous tracheostomy range from 0 to 3.3%, whereas those for open tracheostomy have been reported to be as high as 36%.
		Dislodgement of the tracheostomy tube soon after the procedure may be hazardous as the entry to the trachea is small and deep, hence replacement of the tube may be impossible.
	www.nda.ox.ac.uk /wfsa/html/u15/u1516_01.htm (2050 words)

	Perspectives - Tracheostomy: Easing the Transition from Hospital to Home (Site not responding. Last check: 2007-10-22)
		The patient with a tracheostomy is very vulnerable to respiratory infection, because of the loss of filtration of inspired air through the nasal passages.
		Knowledge of resuscitation techniques is necessary in case of an occluded tracheostomy tube, accidental decannulation, immersion in water, massive bleeding from the tracheostomy, or aspiration.
		However, significant partners or family members must be able to provide all aspects of tracheostomy care and other facets of airway management in emergency situations or when the patient is not able to participate in self- care for a variety of reasons, such as age or lack of dexterity.
	www.perspectivesinnursing.org /v1n3/dixon.html (1998 words)

	Tracheostomy Care -- American Head and Neck Society -- Patient Education
		A tracheostomy is a surgical opening in the trachea (windpipe) to make breathing easier.
		Some tracheostomy tubes have an inner part (or cannula) that is removed and cleaned.
		Hold a tissue or gauze in front of the tracheotomy tube to wipe away the mucus as you cough.
	www.headandneckcancer.org /patienteducation/docs/tracheostomy.php (1331 words)

	Care of the Child with a Chronic Tracheostomy (Site not responding. Last check: 2007-10-22)
		The radius of curvature of the shaft of the tracheostomy tube should leave the axis of the distal portion of the tube in a colinear position with the axis of the child’s trachea.
		The use of metal tracheostomy tubes in children is usually limited to special circumstances such as after tracheal reconstruction or in the event that a tube with an inner cannula is needed.
		Tracheostomy tubes modified by physicians or other caregivers should be used only in urgent situations until a specially ordered custom tracheostomy tube is available.
	www.thoracic.org /ChildWithTracheostomy6.asp (636 words)

	ICU-USA - Tour - Tracheostomy
		A tracheostomy tube may be needed for ICU patients requiring long-term mechanical ventilation, patients unable to cough effectively to clear secretions, and patients with an obstructed or blocked airway.
		The advantages of a tracheostomy tube over the breathing tube are: the patient is usually more comfortable, the patient may be able to drink or eat with the tracheostomy tube in place, and the tracheostomy tube may make it easier for the patient to breathe.
		Patients may be able to speak with a tracheostomy tube in place once they are able to breathe spontaneously (i.e., are off the breathing machine [mechanical ventilator]).
	www.icu-usa.com /tour/procedures/trach.htm (490 words)

	Tracheostomy ward decannulation Factsheet
		Tracheostomy decannulation is the process of removing your child’s tracheostomy and making sure he or she is breathing well without it.
		For instance, if your child is older and therefore using a large size tracheostomy tube, he or she may need to downsize to a smaller size in stages rather than in one go.
		This stage of the process prepares your child for the next stage when the tracheostomy tube is completely removed, and he or she has to breathe normally.
	www.gosh.nhs.uk /factsheets/families/F040121 (1801 words)

	Living with a tracheostomy factsheet
		A tracheostomy is an artificial opening into the windpipe (trachea) which is held open by a tracheostomy tube.
		There are a variety of reasons why a child may need a tracheostomy, ranging from a narrow airway to the need for long term mechanical respiratory support from, for example, a ventilator.
		Tracheostomy nurse specialist: she will probably be your first port of call for any questions you have and will be the main person training you to care for your child’s tracheostomy.
	www.gosh.nhs.uk /factsheets/families/F000305/trac1.html (860 words)

	eMedicine - Tracheostomy : Article by Charles E Morgan, DMD, MD (Site not responding. Last check: 2007-10-22)
		Extra-long tracheostomy tubes are available and should be used in the patient with obesity in whom the distance between the skin and the trachea is too great to be safely bridged by a standard tracheostomy tube.
		Misplacement of the tracheostomy tube into the dreaded "false passage," usually in the pretracheal space, should be suspected in the presence of difficulty ventilating or passing a suction catheter or if subcutaneous air or pneumothorax occurs.
		Tracheostomy has not been demonstrated to pose a greater risk of pneumonia than intubation because both interventions lead to colonization of the airway with potential pathogens.
	www.emedicine.com /ent/topic356.htm (6212 words)

	Tracheostomy - Health and Medical Information produced by doctors - MedicineNet.com
		A tracheostomy is a surgically created opening in the neck which allows direct access to the trachea (the breathing tube).
		A tracheostomy is usually done for one of three reasons: (1) to bypass an obstructed upper airway; (2) to clean and remove secretions from the airway; and (3) to more easily, and usually more safely, deliver oxygen to the lungs.
		It is important to understand that a tracheostomy, as with all surgeries, may involve risks of unsuccessful results, complications, or injury from both known and unforeseen causes.
	www.medicinenet.com /tracheostomy/article.htm (439 words)

	CHEST: Tracheostomy for respiratory failure: we need more answers - editorials (Site not responding. Last check: 2007-10-22)
		Tracheostomy formation is one of the most commonly performed surgical procedures in the critically ill patient who requires prolonged mechanical ventilation, (1,2) Relative to translaryngeal intubation, tracheostomy potentially affords greater patient comfort, more effective pulmonary toilet, increased airway security, and less airway resistance.
		Among patients with a tracheostomy, the nonsurvivors were statistically more likely to be older, have a nonsurgical admission, have the new onset of renal dysfunction, lack placement of a surgically inserted feeding tube, and have a lower nadir hemoglobin level compared to survivors.
		In a previous study (11) of patients requiring prolonged mechanical ventilation, individuals receiving a tracheostomy had a statistically lower mortality rate compared to patients not receiving a tracheostomy, despite having a similar severity of illness at the time of admission to the ICU.
	www.findarticles.com /p/articles/mi_m0984/is_1_125/ai_112903369 (1291 words)

	TRACHEOSTOMY CARE (Site not responding. Last check: 2007-10-22)
		The purpose of this manual is to provide an introductory level of understanding and competency for the student nurse in the provision of care for a patient with a tracheostomy tube.
		A tracheostomy may be emergency, temporary, permanent, or prophylactic.
		Also, depending on the recency of the tracheostomy, sometimes procedures are considered clean, and not sterile.
	www.langara.bc.ca /vnc/trach.htm (1980 words)

	tracheostomy percutaneous (Site not responding. Last check: 2007-10-22)
		As we have not found a formal definition of PT elsewhere, we shall refer to it as the insertion of a tracheostomy tube without direct visualisation of the trachea, using minimal dissection, through the smallest incision possible.
		A tracheostomy tube is then placed over the appropriate size dilator and both are advanced into the trachea.
		The endotracheal tube is removed after confirming proper placement of tracheostomy tube by demonstrating carbon dioxide return.
	pedsccm.wustl.edu /All-Net/english/pulmpage/trache/trachperq.html (569 words)

	Tracheostomy for obstructive sleep apnea
		Tracheostomy is sometimes used for obstructive sleep apnea (OSA).
		A tracheostomy is done only if you have severe OSA, other treatments have failed, and other forms of surgery for the condition are not appropriate.
		Tracheostomy is used infrequently to treat OSA because other, less invasive treatments are effective in most people.
	www.webmd.com /hw/sleep_disorders/hw49093.asp (300 words)

	CHEST: Percutaneous tracheostomy tube obstruction : warning - clinical investigations in critical care (Site not responding. Last check: 2007-10-22)
		Partial tracheostomy tube occlusion (> 25%) was observed in 21 of 37 group 1 patients (57%) and in 1 of 17 group 2 patients (6%; p < 0.005).
		The partial tracheostomy tube obstruction appeared to be due to the posterior membranous tracheal wall encroaching on the tracheostomy tube lumen.
		Therefore, the standard tracheostomy tube was modified to include a shortened posterior bevel (ie, the longest portion of the tracheostomy tube posteriorly) and a decreased length and angle of the tracheostomy tube (Fig 1).
	www.findarticles.com /p/articles/mi_m0984/is_4_122/ai_94121406 (1130 words)

	Tracheostomy Care (Site not responding. Last check: 2007-10-22)
		All patients who are expected to have a tracheostomy tube in-situ for more than a couple of weeks should have a tube as this minimises the risk of it becoming blocked and reduces the amount of suctioning the patient requires.
		The tracheostomy tube can remain in-situ for up to 28-29 days although it is generally changed weekly to prevent crusting developing on the outer tube or the tracheal mucosa adhering to the tracheostomy tube, causing trauma when the tube is eventually removed.
		In the event of the patient requiring to be ventilated the tracheostomy tube is connected to the ambubag via a catheter mount and the patient bagged by hand using oxygen at 10 litres/min.
	www.ngt.org.uk /nursing_midwifery/clin_proc_man/SectionH/TracheostomyCare.htm (1627 words)

	TRACHEOSTOMY : Contact a Family - for families with disabled children: information on rare syndromes and disorders
		A tracheostomy is an artificial opening into the trachea (windpipe) usually between the second and fourth tracheal rings.
		Usually the decision to perform a tracheostomy is reached as a result of many investigations and tests.
		Indications for tracheostomy in the paediatric population differ somewhat from the adult population.
	www.cafamily.org.uk /Direct/t36.html (662 words)

	eMedicine - Percutaneous Tracheostomy : Article by Darius Bliznikas, MD (Site not responding. Last check: 2007-10-22)
		The guidewire and dilator are removed, the cuff of the tracheostomy tube is inflated, and the breathing circuit is connected.
		The obturator and guidewire are removed, the cuff of the tracheostomy tube is inflated, and the appropriate breathing circuit is connected.
		Flexible connecting tubing between the tracheostomy tube and the mechanical ventilator minimizes traction on the tracheostomy tube and decreases pressure on the trachea.
	www.emedicine.com /ent/topic682.htm (4402 words)

	tracheostomy complications (Site not responding. Last check: 2007-10-22)
		A low tracheostomy predisposes to pneumothorax and a tight stoma aggravates the situation.
		Obstruction: Obstruction of the tracheostomy tube is an avoidable and a potentially fatal complication.
		Good securing of the tracheostomy tube is most important to avoid decannulation.
	pedsccm.wustl.edu /All-Net/english/pulmpage/trache/trachcomp.html (644 words)

	Aaron's Tracheostomy Page
		This site is dedicated to my son Aaron who had a tracheostomy for the first 4 years of his life.
		I hope that Aaron's Page will be helpful to others caring for a child with a tracheostomy, or to anyone seeking to learn more about tracheostomies.
		To provide needed tracheostomy information in order to ease some of the anxiety related to caring for a child with a trach.
	www.tracheostomy.com (255 words)

	Tracheostomy definition - Medical Dictionary definitions of popular medical terms
		A tracheostomy may be needed on an emergency basis to permit a person to breathe who has severe narrowing or blockage (obstruction) of their upper airway.
		Tracheostomy may be part of the surgery required for patients who have to have the larynx (voice box) removed because of cancer.
		Tracheostomy may also be used for patients who require long-term support with a breathing machine (ventilator).
	www.medterms.com /script/main/art.asp?articlekey=5831 (285 words)

	Solving Breathing Problems - Getting A Tracheostomy (Site not responding. Last check: 2007-10-22)
		At what point this occurs varies from person to person, but it eventually happens, and you will need a tracheostomy (an opening from the outside of your throat to the inside of your wind pipe or trachea) and a ventilator to assist your breathing.
		Before your breathing becomes compromised and causes complications you should consider an elective tracheostomy which means to prepare and plan for this operation.
		If you elect to have a tracheostomy at the first sign of any subtle change in breathing, your stay in the hospital will be shorter, you will not get pneumonia, you will not deteriorate, and you will benefit by providing yourself with the best airway possible.
	www.alsisnotfatal.com /tracheostomy.html (758 words)

	Complications of Tracheostomy Performed in the ICU: Subthyroid Tracheostomy vs Surgical Cricothyroidotomy -- ...
		Complications of Tracheostomy Performed in the ICU: Subthyroid Tracheostomy vs Surgical Cricothyroidotomy -- François et al.
		Stauffer, JL, Olson, DE, Petty, TL Complications and consequences of endotracheal intubation and tracheostomy.
		Bodenham, A, Cohen, A, Webster, N A clinical evaluation of the "Rapitrach": a bedside percutaneous tracheostomy technique.
	www.chestjournal.org /cgi/content/full/123/1/151 (3272 words)

	Tracheostomy or Noninvasive Ventilation (Site not responding. Last check: 2007-10-22)
		Indications for tracheostomy are primarily the failure of NPPV, excessive secretions, facial trauma, or upper airway obstruction that would not allow for NPPV.
		Indeed, the loss of oral communication can occur with tracheostomy, because air cannot get up to the vocal cords to enable speech if a tracheostomy tube with an inflated cuff is used.
		In the Scandinavian countries, the choice of tracheostomy is an easier one, due to their social services system that can provide 24-hour “home helper” attendant care.
	www.alsa-or.org /treatment/TrachOrNon.htm (1097 words)

	Percutaneous Tracheostomy Tube Obstruction: Warning -- Trottier et al. 122 (4): 1377 -- Chest
		tracheostomy tube obstruction appeared to be due to the posterior
		the tracheostomy tube was slightly shortened and the angle of
		Cooper, RM Use and safety of percutaneous tracheostomy in intensive care: report of a postal survey of ICU practice.
	www.chestjournal.org /cgi/content/full/122/4/1377 (1827 words)

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