A tracheotomy is a surgical means that opens up the windpipe. It is conducted in emergency situations, in the operation theatre, or at the bedside of seriously ill patients. The term tracheostomy is often facilitated interchangeably with tracheotomy. However, tracheostomy generally is the opening itself while a tracheotomy is the process of actual operation.
Under the emergency situation of tracheotomy there is no time to elucidate the procedure or the requirement for it to the patient. The patient is laid down with his or her back with face upward with a pad of rolled-up towel under the shoulders. This placement of the patient makes it comfortable for the physician to feel and view the anatomy in the throat. A local anesthetic is injected into the cricothyroid membrane.
In a well planned tracheotomy, there is time for the doctor to explain and discuss the surgery with the patient, to describe what will happen and what the requirement is. The patient is then administered general anesthesia. The cervix and chest are then sterilized and surgical drapes are placed over the site, setting up a sterile surgical background.
Once it has been decided to conduct a tracheostomy, the surgeon must ascertain if the patient is an acceptable candidate for the surgery and will obtain written informed consent. In addition, the span of motion of the neck needs to be evaluated. The tracheostomy team, encompassing the surgeons and anesthesiologists need to have a discussion on the entire array of the processes and alternatives to the procedure. All equipment must be available and in functioning condition.
A planned and well organized approach to preparation and performance of the process has been manifested to prominently cut down the incidence of procedural set-backs and complications.
There are certain protocols and equipments which include:
Generally Cook Blue Rhino single dilator kit and video bronchoscopy are most commonly facilitated to perform the tracheostomy.
A well qualified and experienced anesthesiologist should be available for secured maintenance and protection of airway, provision of intravenous sedation and performance of bronchoscopy.
An intubation roll and a cricoid hook in addition to open tracheostomy set all are the prereqisits for Tracheostomy.
A small cut is made across the cervix above the sterna notch. The skin is separated and nearby tissue is cleft to expose the trachea. The second or third circle of the trachea is divided to make tracheostomy cavity. Now tracheostomy tube is inserted into the cavity with catheter connected to suction device. The catheter is placed into the trachea for extracting any phlegm in the lungs. After the completion of the extraction process the tube is removed.