Tracheostomy
From Holoprosencephaly
TRACHEOSTOMY
This is a surgical opening in which an indwelling tube is placed into the trachea. This may be temporary or permanent.
Indications
A tracheostomy is performed to bypass an upper airway obstruction, to remove tracheobronchial secretions, to permit the long term use of mechanical ventilation, to prevent aspiration of oral or gastric secretions in the unconscious patient (by closing off the trachea from the esophagus) and to replace the endotracheal tube. There are also may other disease processes and emergency conditions that may this necessary.
Surgery
This procedure is usually performed in the operating room or intensive care unit where the patient’s ventilation can be well-controlled and optimal aseptic technique can be maintained.
An opening is made in the second and third tracheal rings. This opening is called a stoma.
After the trachea is exposed, a cuffed tracheostomy tube is inserted. This attachment is designed to occlude the space between the trachea walls and the tube for mechanical ventilation. The tube is held in place by a collar or ties around the patient’s neck
Complications
Immediately post op there may be bleeding, pneumothorax, or air embolism. Long term complications include airway obstruction due to the accumulation of secretions, infection, dysphagia, tracheal dilation, or tracheal ischemia.
Caring for the Trach
It is important that caregivers always wash their hands and use universal precautions while handling and caring for the trach.
Suction and emergency supplies should always be kept with the child Room air should be humidified
Special precaution should be taken to avoid obstruction of the airway
Caution should be used during bathing, no swimming or showering
Avoid wearing fuzzy clothing or having furry stuffed animals near the trach
Avoid dusty or sandy areas
Be aware of symptoms of infection and airway obstruction. Medical attention should be sought immediately for these problems
Caregivers should be specially trained on how to give CPR to a child with a trach
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
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For information about dealing with other potential health problems, treatments and medications, please visit our Miscellaneous Health Information category.
Click here to read what specialists have to say about caring for children with Holoprosencephaly: Doctor Q&A
