Contemporary issues in adult tracheostomy management

Airway assessment and management is one of the primary responsibilities of nurses caring for the critically ill adult. Common types of artificial airways, such as endotracheal and tracheostomy tubes, require clinicians to have a complete understanding of indications, complications, and clinical applications. Although tracheostomy tubes are used to a lesser extent than endotracheal tubes in most ICUs, their use typically requires additional education and training because of the complexity and diversity of available tubes, care of surgical site, and other related nursing care issues. The purpose of this article is to provide a review of current practice trends for those caring for the adult patient who has a tracheostomy tube. The first section of the article is an overview of the indications, surgical techniques, and types of tubes used in the critical care setting. The second section examines specific aspects of nursing care of patients who have tracheostomy tubes.