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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

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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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Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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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...
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Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

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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...
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Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
7.2K
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

2.2K
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:
2.2K
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

2.9K
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...
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Tracheostomy timing affects stroke recovery.

Jennifer A Villwock1, Mark R Villwock2, Eric M Deshaies2

  • 1Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|February 22, 2014
PubMed
Summary

Early tracheostomy in stroke patients significantly reduces ventilator-associated pneumonia and hospital costs. This early intervention (≤10 days) leads to shorter hospital stays and lower overall expenses for stroke care.

Keywords:
Tracheostomyneurocritical careoutcomestroketracheostomy timing

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Health Services Research

Background:

  • The optimal timing for tracheostomy in stroke patients with airway protection deficits is debated.
  • Early tracheostomy (ET) is proposed to decrease pneumonia, sedative use, length of stay, and mortality compared to late tracheostomy (LT).

Purpose of the Study:

  • To investigate the impact of tracheostomy timing on stroke patient outcomes.
  • To compare early tracheostomy (≤10 days) versus late tracheostomy (11-25 days) in stroke patients.

Main Methods:

  • Analysis of the Nationwide Inpatient Sample (2008-2010) including 13,165 stroke cases.
  • Comparison of outcomes between ET and LT groups using t tests and chi-squared tests.
  • Multivariable models adjusted for confounding factors to assess outcome measures.

Main Results:

  • ET group (5591 patients) showed a significant reduction in ventilator-associated pneumonia odds compared to the LT group (7574 patients) (OR: 0.688, P=0.026).
  • ET was associated with a significantly shorter length of stay (P < 0.001).
  • ET resulted in an 18% reduction in total hospital costs (P < 0.001).

Conclusions:

  • Early tracheostomy in stroke patients may decrease ventilator-associated pneumonia incidence.
  • This can lead to shorter hospital stays and reduced total hospital costs.
  • Further investigation in prospective multicenter trials is warranted.