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Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

430
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...
430
Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

298
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
298
Suctioning the Oropharyngeal Airway01:25

Suctioning the Oropharyngeal Airway

185
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
185
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

123
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...
123
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

178
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...
178
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

137
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:
137

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Tympanostomy Tube Insertion With and Without Adenoidectomy.

Z Jason Qian1,2, Mai Thy Truong3, Jennifer C Alyono3

  • 1Department of Otolaryngology, UC San Diego School of Medicine, La Jolla, California.

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|October 17, 2024
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Adenoidectomy with tympanostomy tubes (TTs) in children under 4 reduced antibiotic use but not repeat tube insertions. In children 4 and older, adenoidectomy and TTs lowered repeat insertions and antibiotic use, suggesting benefits for older children.

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Health Services Research

Background:

  • The efficacy of adenoidectomy alongside tympanostomy tube (TT) insertion for otologic outcomes remains debated due to prior research limitations.
  • Existing studies often suffer from small sample sizes, varied designs, and inconsistent outcome measures, hindering clear interpretation.

Purpose of the Study:

  • To assess the association between adenoidectomy and otologic outcomes in a large US population of children undergoing TT insertion.
  • To provide generalizable evidence for clinical decision-making regarding combined adenoidectomy and TT procedures.

Main Methods:

  • A matched cohort study utilized claims data from the Merative MarketScan Research Databases (2007-2021).
  • Included were 601,848 children receiving TTs, with a focus on those undergoing simultaneous adenoidectomy and TT insertion (Ad+TT).
  • Controls without adenoidectomy were matched by age, sex, and prior TT procedures; outcomes analyzed included repeat TT insertions and oral antibiotic prescriptions.

Main Results:

  • In children younger than 4 years, Ad+TT was linked to decreased oral antibiotic use (OR, 0.59) but increased repeat TT insertions (OR, 1.24).
  • In children aged 4 years and older, Ad+TT was associated with reduced odds of repeat TT insertions (OR, 0.78) and subsequent oral antibiotic prescriptions (OR, 0.63).

Conclusions:

  • For children under 4, Ad+TT may reduce antibiotic courses but does not decrease repeat TT insertions.
  • For children 4 and older, Ad+TT demonstrates a benefit by reducing both repeat TT insertions and antibiotic use, supporting its consideration for improved otologic outcomes.