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Related Concept Videos

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...
311
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...
91
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

99
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:
99
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

125
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...
125
Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

449
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
449
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

352
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...
352

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Related Experiment Video

Updated: May 16, 2025

The Microscopic Transcanal Approach in Stapes Surgery Revisited
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Protocol implementation for in-office manual tympanostomy tube insertion.

Kelly Giroux1, Logan F McColl2, Christian Harter3

  • 1Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, 43205, USA.

International Journal of Pediatric Otorhinolaryngology
|April 4, 2025
PubMed
Summary

Manual in-office bilateral myringotomy/tympanostomy tube insertion (BTI) offers a safe, cost-effective alternative to general anesthesia for pediatric ear infections. This approach significantly improves patient access and satisfaction while reducing healthcare expenses.

Keywords:
Eustachian tube dysfunctionIn-office procedureMyringotomy tube insertionOtitis media with effusionRecurrent acute otitis mediaTopical pain controlTympanostomy tube insertion

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Health Services Research

Background:

  • Bilateral myringotomy/tympanostomy tube insertion (BTI) alleviates acute otitis media and chronic otitis media with effusion in children.
  • In-office BTI (IO-BTI) avoids general anesthesia risks but often relies on costly proprietary devices.
  • A manual IO-BTI protocol aims to reduce costs, improve access, and maintain patient benefits.

Purpose of the Study:

  • To develop and evaluate a protocol for manual IO-BTI without single-use devices.
  • To assess caregiver satisfaction, surgical outcomes, and cost-effectiveness compared to other BTI methods.

Main Methods:

  • A protocol for manual IO-BTI was implemented in an ambulatory clinic.
  • 178 pediatric patients' caregivers completed satisfaction surveys.
  • Retrospective chart review analyzed post-operative pain, tube extrusion, and plugging.
  • Cost analysis compared manual IO-BTI, device-assisted IO-BTI, and operating room BTI.

Main Results:

  • Caregiver satisfaction rate was 99%.
  • Low rates of post-operative pain (0.7%), premature extrusion (0.8%), and tube plugging (1.5%) were observed.
  • Manual IO-BTI was 1.5x and 6x less expensive than single-use device IO-BTI and operating room BTI, respectively.

Conclusions:

  • Manual IO-BTI is a safe and feasible procedure for pediatric patients.
  • This method offers high caregiver satisfaction and positive surgical outcomes.
  • Manual IO-BTI significantly reduces healthcare costs and improves access to care.