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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 Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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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:
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Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

4.0K
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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Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
2.7K
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

2.2K
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
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Author Spotlight: Learning Systematic Bronchoscopy in a Simulation-Base Setting
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Author Spotlight: Learning Systematic Bronchoscopy in a Simulation-Base Setting

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Pre-decannulation flexible bronchoscopy in tracheostomized children.

Anil Sachdev1, Amrit Ghimiri2, Neeraj Gupta3

  • 1Division of Pediatric Pulmonology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110060, India. anilcriticare@gmail.com.

Pediatric Surgery International
|September 8, 2017
PubMed
Summary

Flexible fiberoptic bronchoscopy (FFB) before tracheostomy decannulation in children identifies airway issues, guiding interventions and improving success rates. This evaluation highlights FFB

Keywords:
DecannulationFlexible fiberoptic bronchoscopyPediatric airwayTracheostomy

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Guidelines for Elective Pediatric Fiberoptic Intubation
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Area of Science:

  • Pediatric Pulmonology
  • Otolaryngology
  • Critical Care Medicine

Background:

  • Tracheostomy is a common procedure in pediatric patients requiring prolonged airway support.
  • Decannulation, the process of removing the tracheostomy tube, can be complex and may be associated with complications.
  • Assessing airway patency and identifying potential obstructions prior to decannulation is crucial for successful outcomes.

Purpose of the Study:

  • To evaluate the clinical utility and benefits of performing flexible fiberoptic bronchoscopy (FFB) before attempting tracheostomy decannulation in pediatric patients.
  • To determine if FFB can predict decannulation success or failure and guide necessary interventions.

Main Methods:

  • A retrospective review of 49 pediatric patients who underwent tracheostomy decannulation attempts.
  • Data collected included patient demographics, tracheostomy indications, pre-tracheostomy and pre-decannulation bronchoscopic findings, and duration of tracheostomy.
  • Interventions following FFB and decannulation outcomes were recorded, adhering to departmental policies.

Main Results:

  • Forty-nine patients were analyzed, with a median age of 3 years and median tracheostomy duration of 8 months.
  • Flexible fiberoptic bronchoscopy revealed abnormalities in 36 patients (73.5%), with airway granulation being the most common (51%).
  • Successful decannulation without intervention occurred in 46.9% of cases (12 with normal FFB). 30.6% required surgical intervention prior to decannulation, and 5 patients experienced decannulation failure.

Conclusions:

  • Pre-decannulation flexible fiberoptic bronchoscopy is a valuable tool in pediatric patients with tracheostomies.
  • FFB aids in identifying potential causes of decannulation failure, such as granulation tissue.
  • The findings from FFB assist in planning appropriate interventions, thereby optimizing the decannulation process and improving patient outcomes.