Tracheostomy

It is performed as bedside procedure, thus it reduces the expenses for transportation and arrangement of operation room.

Tracheostomy in ventilated patients may decrease sedation, which enhances comfort and mobility.

It is used for site survey to prevent complications from direct injury.

Patient Positioning:

Assist the patient to lay down in a supine position with their neck should be straight and give support from backside.

Fig. Tracheostomy

Step 1: Anesthesia and Sedation

Give local or general anesthesia as required.

 Step 2: Identification of incision site

Surgeons should finalize the incision site as cricoid cartilage and second and third tracheal rings.

Step 3: Perform the incision

Surgeons will perform a horizontal or vertical incision through the skin, between the cricoid cartilage and the sternal notch.

Step 4: Tracheal entry

Surgeons create an opening in the tracheal region and give a cut through cricothyroid membrane and first tracheal ring.

Place tracheostomy tube correctly within the trachea opening.

Step 5: Tube Securement and Closure

The tracheostomy tube is secured by surgeon and then skin incision is closed with the help of absorbable sutures.

The two types of tracheostomies as follows:

In open tracheostomy procedure, surgeons create a direct opening into the trachea to ensure a safe airway.

In percutaneous tracheostomy, it also creates a tracheal opening for airway access but without any formal incision it was performed as bedside procedure.

Bleeding can occur in between or post-operation due to injury to neck or tracheal mucosa blood vessels.

Post surgery may cause surgical site infections, cellulitis, deep neck infections, and systemic symptoms.

Tracheal wall injury during tracheostomy may cause stenosis and fistula complications.

Tracheostomy sites may form granulation tissue over time, which cause stoma stenosis.