When the Trach tube comes out, how do you ventilate the patient? - page 2
I can't find this in my book anywhere, when the trach comes out accidentaly, and you want to ventilate the patient with the ambu bag, do you ventilate their mouth or their stoma? I always thought you would ventilate the stoma but... Read More
- 1Oct 10, '10 by GHGoonetteNo (HORRORS! Pulling the trachea out..!!!) the tracheotomy is the surgical procedure of making an opening into the trachea for the purpose of establishing an airway in a person whose upper airway is obstructed. You got that right, but the resultant opening is kept patent by insertion of a tube, of which there are different types. This opening is called a stoma, hence the name tracheostomy. The trachea is not pulled out! Unless, of course, you have a grudge against that particular patient...Last edit by GHGoonette on Oct 10, '10 : Reason: Minor correction
- 1Oct 13, '10 by GreyGullThe main thing is to know is what type of opening the patient has and where it goes or doesn't go. Then you can more easily refer to the proper P&P in your manual.
Quote from Christine Cameron-DoThis depends on the type of surgeries done in your hospital. Some doctors like to differentiate between -otomy as the incision meant to close when something is not there holding it open and -ostomy with the ostomy being more permanent and will not close once the trach is removed.No (HORRORS! Pulling the trachea out..!!!) the tracheotomy is the surgical procedure of making an opening into the trachea for the purpose of establishing an airway in a person whose upper airway is obstructed. You got that right, but the resultant opening is kept patent by insertion of a tube, of which there are different types. This opening is called a stoma, hence the name tracheostomy. The trachea is not pulled out! Unless, of course, you have a grudge against that particular patient...
I have also posted a photo here of a stoma being formed when the trachea is brought to the surface. It is a HORRORS! photo and I apologize if some are squeamish. (Google Images is a great tool - yeah that posters and graphics display thing again)
To form an -ostomy (according to the purist of ENTs surgeons), after a laryngectomy the trachea is brought to the surface and the stoma is formed. A more permanent ostomy or stoma can also be created without the laryngectomy if the patient needs tracheal access but still has their larynx some upper airway access. Of course many use the terms interchangeably and may not actually realize what their patient has.
Example of a stoma s/p laryngectomy (you are looking directly into the trachea)
In the above photo you will see a little tag stick out which is a prosthetic speaking valve (Blom-Singer) that fits into the fistula between the trachea and esophagus.
Below is a neck resection with laryngectomy where the trachea is being prepared to form a stoma at the surface.
Text that goes with that photo:
Diagram of a tracheostomy s/p laryngectomy.
This is a tracheotomy incision that needs a little TLC and Bacitracin.
Tracheotomy incision with a trach
Note that there is still an intact trachea above the trach.Last edit by GreyGull on Oct 13, '10
- 3Oct 20, '10 by VickyRN Asst. AdminA big thanks to GreyGull for your amazing insight and knowledge. Thank you for so freely sharing out of your vast reservoir of expertise. I have learned much from your posts on this thread.
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