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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 II: Procedure01:25

Tracheostomy Care II: Procedure

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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...
149
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

152
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:
152
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...
480
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

487
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...
487
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

445
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
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The Rigid Tube as an Alternative in Controlling the Problematic Airway
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Occlusive Tight Strapping for Tracheostomy Decannulation; Is it Safe?

Geetanjali Tolia Chilkoti1, Nikita Mary Mundakel1, Nitin Kataria1

  • 1Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Shahdara, Delhi 110095 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|August 12, 2024
PubMed
Summary

Massive subcutaneous emphysema (SE) after tracheostomy decannulation is rare. This case suggests a tight occlusive dressing may cause SE, highlighting the need for careful decannulation techniques.

Keywords:
DecannulationSubcutaneous emphysemaTracheostomy

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Area of Science:

  • Medicine
  • Surgery
  • Pulmonology

Background:

  • Decannulation after tracheostomy is a critical step in patient recovery.
  • Subcutaneous emphysema (SE) is an uncommon complication following decannulation.
  • Previous reports on SE post-decannulation are scarce.

Purpose of the Study:

  • To report a rare case of massive subcutaneous emphysema (SE) after short-term tracheostomy decannulation.
  • To discuss potential causes and methods of SE following decannulation.
  • To hypothesize the role of specific decannulation techniques in SE development.

Main Methods:

  • Case report of a patient experiencing massive SE post-tracheostomy decannulation.
  • Review of literature on decannulation methods.
  • Analysis of potential etiologies for SE.

Main Results:

  • A case of massive subcutaneous emphysema was observed after tracheostomy decannulation.
  • The tight occlusive dressing method used for decannulation is hypothesized as the cause.
  • SE following decannulation is a rare but significant complication.

Conclusions:

  • Massive subcutaneous emphysema following tracheostomy decannulation is a rare event.
  • The use of tight occlusive dressings during decannulation may contribute to SE.
  • Further investigation into decannulation techniques and SE prevention is warranted.