The Artificial Airway: Tracheostomy

“For some investigators, ‘weaning success’ is defined as sustained spontaneous, unassisted breathing with or without an artificial airway, and for others it is defined as sustained extubation” (Cook 2000). Whatever the nurse and physician see as the definition to weaning is far less important than ensuring their patient is weaned at the correct time. Allowing a patient to remain intubated and on mechanical ventilation when it is no longer needed, only puts the patient at risk for problems beyond the reason for initial intubation.

The trachea (windpipe) is a hollow tube that connects the voice box to the bronchi of the lungs, allowing the passage of air to flow through. The trachea is lined with ciliated epithelial cells, which have long root hairs called Celia, which removes unwanted substances up through the windpipe so it doesn’t block it.

INDICATIONS FOR SURGERY: The patient is a 62-year-old Caucasian male who has pneumonia. The patient has been on a ventilator for over 2 weeks and appears to require long-term ventilator. The patient is undergoing tracheostomy for this purpose.

The chest tube will not have any more drainage coming from it for fluids and when the lung is re-expanded in the case of a collapsed lung via

However one would be lax if they didn’t take this as a serious situation. A patient with a partial airway obstruction can be presenting in a couple different ways. In the stable patient the signs may be mild and mostly just worrisome and irritating to the patient. In these cases even thou there is a need to obtain definitive care in is imperative to remain calm so as not to worry the patient. One should consider immediate administration of oxygen by non rebreather to make sure the patient remains stable along with encouraging the patient to cough if the feel the need. However in an unstable patient you would expect to hear noisy respirations, coughing and gagging. As the patient continues to deteriorate the coughing will become feeble and signs of respiratory distress such as anxiety, lethargy and even cyanosis will become apparent.[Joynt 2015] In these cases it is imperative to initiate aggressive oxygen therapy immediately. In cases such as these a paramedic could employ several different methods to ensure the patient doesn’t progress to a complete obstruction. First would be to visualize as much of the airway as possible with the naked eye and remove any obstruction visible. However this is not too be confused with the blind figure sweep of the past. One should never attempt to remove an object that they can not see. Another

A tracheostomy, or trach, is a surgically created opening in the trachea. A tracheostomy tube, or trach tube, is a tube that is placed in this opening to help with breathing. It is important to take good care of your trach and trach tube. This will help you stay safe and free from infection.

The use of an invasive device in the hospital, including invasive tubes for breathing (endotracheal or tracheostomy tube) or feeding (nasogastric, enteral or intravenous tubes).

In hospitalized patients with tracheostomy tubes, does using the CoughAssist with suctioning, compared to just suctioning, reduce the number times the patient requires suctioning?

I tried diaphragmatic breathing and alternate nostril breathing. I am still having a bit of hard time using diaphragmatic breathing while I am sitting. However, I've been doing laying down and it has worked wonders. I was actually able to fall asleep faster and slept more soundly than before. If my son would actually sleep through the night, it would probably be the best sleep I have had in over 3 years. My attempt at alternate nostril breathing did not go so well. Each attempt always left me with a stuffed up nostril. The cleansing breath exercise is already part of my daily routine. I use it in conjunction with the legs up the wall pose in order to relieve stress and tension from my neck and

The respiratory system is one of the main bodily systems which function-is to maintain adequate airflow from the environment to the lungs and to provide the oxygen the human body needs to maintain normal function. The respiratory system includes the nasal cavity, pharynx, larynx, trachea, bronchus and lungs. In 1974, the designation “respiratory therapist” became standard, and the role of the respiratory therapist as a health professional is concerned with assessment, diagnostic testing, treatment, education, and patients with problems with cardiopulmonary system. The therapies available for respiratory therapists to perform include aerosol drug therapy, humanity therapy, gas therapy, airway clearance therapy and lung expansion therapy. As

The patient was a 76-year old man status-post right left amputation and spleenectomy secondary to a work accident that required multiple surgeries and tracheostomy for 2.5 months. In the years following the patient suffered dyspnea on exertion and was admitted to the hospital in 2010 for stridor and long segment tracheal stenosis confirmed via bronchoscopy. The bronchoscopy revealed stenosis originating at the cricoid cartilage and affecting

The optimal timing for elective tracheostomy is still a subject of debate. In the1980s, tracheostomy was considered “early” if it was performed within 21 days of endotracheal intubation. Otorhinolaryngology literatures recommended performance of tracheostomy within 3 days of intubation to prevent vocal cord damage from endotracheal intubation [13]. Several studies have shown early tracheostomy (within 7 days) reduced the duration of mechanical ventilation and the length of ICU stay as well as overall hospital length of stay in trauma patients [14]. The early tracheostomy group had a statistically significant lower incidence of pneumonia (78% vs. 96%, p < 0.05) compared to late tracheostomy (greater than 7 days) [14, 15, 16]. It is believed

There are several types of mechanical ventilators and ventilator mode settings. All of them have distinctive features that can aid patients towards recovery and therapy. Professionals in the medical field would agree that medical interventions such as intubation and mechanical ventilation can critically save and support patients who are suffering from severe acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). A type of ventilation called the high frequency percussive ventilation (HFPV) is being advocated as a vital therapy to patients with ARDS as well as an effective method in treating smoke inhalation injury in burn patients. Compared to the conventional mode of ventilation, HFPV can greatly improve oxygenation and ventilation. Furthermore, HFPV is now being widely used especially when conventional modes of ventilation cannot achieve oxygenation and ventilation goals (Kunugiyama and Schulman, 2012).

The mannequin is based on a commercially available medical training patient mannequin. This mannequin supports many clinical activities. Complete airway management can be practiced including mask ventilation, endotracheal and endobronchial intubation, cricothyrotomy and trans tracheal jet ventilation. The airway can be made "difficult" in several ways including changes in the neck/head alignment, incorporation of an intraparietal mass, and laryngospasm. Other clinical features supported by the mannequin include ability to placemen of peripheral and central intravenous lines, a thumb that can be stimulated by real clinical nerve stimulators (and responds appropriately depending on what drugs have been given), palpable radial and carotid pulses,

Tracheostomys may be required for long term control of excessive bronchial secretions, particularly in those with reduced consciousness or to maintain an