Tracheostomy Questions & Answers

Updated: Oct 12, 2021
  • Author: Jonathan P Lindman, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
  • Print
Questions & Answers

Overview

When is a tracheostomy most often performed?

Which problem does a tracheostomy address?

How does a tracheostomy correct airway obstruction?

What are the differences between tracheostomy and tracheotomy?

What is the anatomy of the trachea?

What are the indications for tracheostomy?

When is tracheostomy indicated for pulmonary hygiene?

What is the role of a cuffed tube in a tracheostomy?

When is a tracheostomy procedure recommended by the American College of Chest Physicians?

What is the role of tracheostomy in the prevention of aspiration?

For which conditions is tracheostomy considered at diagnosis?

What are the contraindications for tracheostomy?

Which end-of-life issues should be considered prior to tracheostomy?

What are the differences between an open and percutaneous technique tracheostomy?

How should tracheostomy technique be selected?

What are the advantages and disadvantages of percutaneous tracheostomy?

Which patients are unfavorable candidates for tracheostomy?

What are is he complication rate for tracheostomy procedures?

What is the role of ultrasonography in tracheostomy?

Which muscles are vulnerable to injury during a tracheostomy?

Which nerves, and veins are vulnerable to injury during tracheostomy?

Which great vessels are vulnerable to injury during tracheostomy?

Which tissue should be divided carefully during a tracheostomy?

Periprocedural Care

What patient education about tracheostomy care must be given prior to hospital discharge?

What discussion should the surgeon, patient, and family have before a tracheostomy procedure?

What is a tracheostomy tube?

What are the ideal characteristics of a tracheostomy tube?

What should be included in a tracheostomy kit?

How is tracheostomy tube size determined?

How do tracheostomy tubes differ among patients?

What can occur if a tracheostomy tube is too long or short?

When is use of an extra-long tracheostomy tube indicated?

What are the advantages and disadvantages of the Bivona tracheostomy tube?

What is the cannulae of a tracheostomy tube?

What are the benefits of a removable tracheostomy tube?

What is the purpose of a cuffed tracheostomy tube?

Why must cuffed tracheostomy tubes be regularly monitored in patients on mechanical ventilation?

What are the indications for a cuffed tracheostomy tube?

What are the contraindications for a cuffed tracheostomy tube?

What are the indications and contraindications for an uncuffed tracheostomy tube?

What are fenestrated tracheostomy tubes?

What is purpose of a neck plate on a tracheostomy tube?

What are the benefits of an adjustable flange on a tracheostomy tube?

What is the role of the pilot balloon on a cuffed tracheostomy tube?

What is the role of the introducer/obturator in a tracheostomy procedure?

When are tubes replaced to improve cosmetic appearance after a tracheostomy procedure?

What modifications are possible to tracheostomy equipment to improve fit?

Which equipment is used to perform percutaneous tracheostomy?

Which type anesthesia is needed in a tracheostomy procedure?

Which anesthesia is used in elective tracheostomy procedure?

Which anesthesia should be used for deep sedation during tracheostomy procedures?

How are serious complications of a tracheostomy prevented?

What is a common respiratory complication during tracheostomy?

What steps should be taken to care for intraoperative bleeding during tracheostomy?

What causes pneumothorax in tracheostomy?

What paratracheal structures are vulnerable to injury during a tracheostomy?

Although rare, which complications can occur after a tracheostomy procedure?

What steps should be taken if bleeding occurs immediately following tracheostomy?

What lowers the risk of mucus plugging following tracheostomy?

How is tracheitis managed following tracheostomy?

How are post-tracheostomy infections prevented?

How should tracheostomy tubes be replaced?

Which airway management techniques are used following tracheostomy?

What cause subcutaneous emphysema following tracheostomy?

What causes atelectasis following tracheostomy?

What is the prevalence and mortality rate of tracheoinnominate fistula following tracheostomy?

What are the signs of impending tracheoinnominate fistula following tracheostomy?

What is the treatment of catastrophic bleeding from a post-tracheostomy tracheoinnominate fistula?

How is bleeding at the tip of the tracheostomy tube detected and treated?

What causes tracheomalacia following tracheostomy?

What causes laryngeal stenosis following tracheostomy?

What causes tracheal stenosis following tracheostomy?

What causes tracheoesophageal fistula following tracheostomy?

Where can granulation occur following tracheostomy?

Can visible tracheostomy scars be treated?

What causes plugging trials or decannulation to fail following tracheostomy?

What are the complication rates of percutaneous and open tracheostomy procedures?

What are the possible complications of prolonged intubation following tracheostomy?

Does tracheostomy increase the risk of pneumonia compared to intubation?

When is the timing of a tracheostomy controversial?

What are indications for pediatric tracheotomy?

How long does a patient typically retain a tracheostomy?

What is the recommended postoperative care for a tracheostomy?

What are the steps for suctioning a tracheostomy?

What is the ideal pressure within a cuffed tracheostomy tube?

How are mucus secretions managed following tracheostomy?

When should the tracheostomy tube be removed?

When should a patient begin speaking following tracheostomy?

When can a patient begin to swallow following tracheostomy?

Technique

Can intubation replace or precede tracheostomy?

What are supplements to intubation as an alternative to tracheostomy?

What is a percutaneous transtracheal jet ventilation (PTJV)?

What is an alternative to tracheostomy for improved pulmonary hygiene?

What are the advantages and disadvantages of emergent cricothyrotomy?

What are the advantages and disadvantages of elective cricothyrotomy?

When is emergent tracheostomy indicated?

When should an urgent tracheostomy be performed?

When is elective tracheostomy performed?

How is cricothyrotomy performed?

What position should the patient be placed in for an open tracheostomy?

How is an open tracheostomy performed?

In an open tracheostomy, what should be done following preparation for transfer of circuitry tubes?

In an open tracheostomy, what should be done for a T-shaped tracheal opening?

In an open tracheostomy, what should be done for a U or H-shaped tracheal opening?

In an open tracheostomy, when can a simple horizontal incision be used for?

In a tracheostomy, how is a permanent stoma created?

In a tracheostomy, what steps are completed after the trachea is entered?

How is percutaneous tracheostomy performed?

When should a cricothyrotomy be performed?

Which factors should be considered when deciding between cricothyrotomy and tracheostomy?

What are risks and benefits of tracheostomy in obese patient?

What tracheostomy techniques used to create a permanent airway in obese patients?

Which pediatric patients are at higher risk for operative and postoperative complications?

What are the challenges in performing pediatric tracheostomy?

What techniques are used in pediatric tracheostomy?

When should a pediatric tracheostomy be performed?

How is pediatric tracheostomy sutured?

What type of tracheostomy tubes are used for pediatric patients?