Tracheostomy: Procedure and Tubes

Tracheostomy is a surgical technique that involves the creation of an opening in the trachea to establish a patent airway, bypass an upper airway obstruction, remove secretions, enable long-term mechanical ventilation, and aid in ventilator weaning.

It is generally performed under local or general anesthesia in a sterile environment.

An incision is made on the anterior neck extending to the trachea, and a tracheostomy tube is inserted and secured with a Velcro strip.

Tracheostomy tubes can be cuffed or cuffless and fenestrated or non-fenestrated.

A cuffed tube is used for patients requiring mechanical ventilation, while a cuffless tube is suitable for long-term tracheostomies without mechanical ventilation.

A fenestrated tube has holes in the shaft, enabling breathing and speech.

Next, post-operative care involves cuff inflation, tube placement confirmation, suturing, and applying a sterile dressing.

Lastly, nursing responsibilities include regular tracheostomy site assessment, sterile dressing changes, monitoring cuff inflation pressure, suctioning the tracheostomy tube, and facilitating communication for speech difficulties.