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Tracheostomy: Procedure and Tubes

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...

Tracheostomy Care I: Pre-procedural Steps

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:

Tracheostomy Care II: Procedure

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

Trachea

Trachea

The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...

Tracheostomy Decannulation

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...

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Updated: Jun 16, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Natural course following pediatric tracheostomy.

Tom Spentzas¹, Michael Auth, Patricia Hess

¹Division of Critical Care Medicine, Department of Pediatrics, University of Tennessee, TN, USA. tspentza@utmem.edu

Journal of Intensive Care Medicine

|January 23, 2010

Summary

Pediatric tracheostomy is most commonly due to chronic lung disease or subglottic stenosis, leading to extended hospital stays. Factors like pulmonary hypertension and reflux predict longer hospitalizations for these pediatric patients.

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Area of Science:

Pediatric Critical Care Medicine
Respiratory Medicine
Pediatric Surgery

Background:

Tracheostomy in children is a significant intervention with varied indications and outcomes.
Understanding the hospital course and predictors of prolonged stay is crucial for resource allocation and patient management.

Purpose of the Study:

To detail the hospital course, diagnoses, and demographics of pediatric patients undergoing tracheostomy.
To identify factors influencing length of stay and home ventilation requirements.

Main Methods:

Retrospective, descriptive review of patient records.
Analysis of data from an academic tertiary Pediatric Critical Care Unit.

Main Results:

141 pediatric patients (1 month-20 years) were studied; hospital stay ranged from 14-280 days.
Common indications included chronic lung disease (CLD), subglottic stenosis, and neurological issues.
Prolonged stay was associated with pulmonary hypertension, gastrointestinal reflux, failure to thrive, feeding issues, and tracheitis.

Conclusions:

CLD and subglottic stenosis are primary drivers for pediatric tracheostomy, followed by neurological conditions.
Accurate diagnosis aids in predicting hospitalization length and home ventilation needs.
Pulmonary hypertension, reflux, and failure to thrive are key predictors in complex cases, with low initial mortality but increased long-term risk.