Tracheostomy Objectives

Question 1

discuss the indications for a tracheostomy insertion

Answer 1

• has an obstructed upper airway
• likely to need prolonged artificial ventilation
• unable to independently maintain their airway
• undergoing upper airway surgery

Question 2

explain percutaneous tracheostomy

Answer 2

Percutaneous Dilation Tracheostomy (PDT) - bedside procedure commonly performed in critical care settings

Question 3

explain surgical tracheostomy

Answer 3

Surgical tracheostomy - elective surgical tracheostomy- performed under GA in operating theatre.

Question 4

outline complications that may occur with a tracheostomy tube and discuss how these may be minimised/prevented

Answer 4

• blocked or obstructed tracheostomy - suction, replace inner cannula
• displaced/dislodged traceostomy tube - ensure tracheostomy is supported during movement
• tracheal damage or ischemia - ensure pressure of cuff is maintained between 20-30cmH2O
• speaking valve intolerance - ensure cuff is fully deflated

Question 5

you are caring for a patient with a tracheostomy tube who is on full mechanical ventilation. Whilst transferring the patient to a chair, the tube becomes dislodged. As the bedside nurse, what are your immediate actions?

Answer 5

• activate medical emergency

- follow tracheostomy management algorithm

Question 6

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