Definitions:
TRACHEOTOMY: Incision made below the
cricoid cartilage through the 2nd-4th
tracheal rings
TRACHEOSTOMY: The opening or stoma made
by this incision.
TRACHEOSTOMY TUBE: Artificial airway
inserted into the trachea during
tracheotomy
INDICATIONS FOR TRACHEOSTOMY
• Bypass acute upper airway obstruction.
• Chronic upper airway obstruction.
• Facilitate weaning from mechanical ventilation by decreasing anatomical deadspace.
• Prevention / treatment of retained tracheobronchial secretions.
• Prevention of pulmonary aspiration.
COMPONENTS OF TRACHEOSTOMY TUBE
1. Outer tube
2. Inner tube: Fits snugly into outer tube, can be easily removed for cleaning.
3. Flange: Flat plastic plate attached to outer tube - lies flush against the patient’s
neck.
4. 15mm outer diameter termination: Fits all ventilator and respiratory equipment.
All remaining features are optional
5. Cuff: Inflatable air reservoir (high volume, low pressure) - helps anchor the
tracheostomy tube in place and provides maximum airway sealing with the least amount of local compression. To inflate, air is injected via the...
6. Air inlet valve: One way valve that prevents spontaneous escape of the injected air.
7. Air inlet line: Route for air from air inlet valve to cuff.
8. Pilot cuff: Serves as an indicator of the amount of air in the cuff
9. Fenestration: Hole situated on the curve of the outer tube - used to enhance airflow in
and out of the trachea. Single or multiple fenestrations are available.
10. Speaking valve / tracheostomy button or cap: Used to occlude the tracheostomy tube
opening (a) former - during expiration to facilitate speech and swallow,
(b) latter - during both inspiration and expiration prior to decannulation.
BEDSIDE EQUIPMENT
Every patient with a tracheostomy tube should have the following equipment available at the bedside:
• Spare tracheostomy tubes Same size and type as patient is wearing.
Smaller size
• Tracheal dilator.
• Suctioning equipment Suction machine fitted with filter; suction tubing;
suction catheters (see suctioning page for sizes);
gloves (as below); bottle of sterile water to rinse tubing - change daily.
Ensure equipment is assembled and working
properly.
• Humidification equipment Equipment depends on method used - see
humidification page.
Ensure equipment is assembled and working
properly.
• Gloves Non-sterile **
Sterile gloves (for suctioning)
• Infectious waste bag
• Dry clean container for holding the speaking valve, occlusive cap/button or spare inner cannula when not in use. (Get from theatre)
**Natural rubber latex gloves to be used by all except those who have latex allergy.
Nitrile gloves to be used by those with latex allergy.
