Tracheostomy

Tracheostomy can be a life-saving operation and all doctors need to have knowledge of it.

Definitions

Tracheotomy is an opening in the trachea to permit air entry. A tracheostomy implies that the edges of the trachea have united with the skin of the neck to form a stoma or opening. Once the trachea has been opened it is usual to put a tracheostomy tube (Figure 34.1a,b) in the trachea to keep the hole open. This tracheostomy tube can then be attached to tubing for ventilation, used as a channel for suction catheters or attached to a speaking valve when the patient is well enough to be able to relearn speech (Figure 34.2).

Indications

There are many situations where a tracheostomy can be helpful, but most fall into one of the following categories:

Some common causes of upper airway obstruction are shown in Figure 34.3.

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