What Do We Need to Know?
What information do you want to know immediately?
- Does the patient have a connection between their face and their
lungs?
- Has the patient had a laryngectomy?
- How many airways do I have to work with – 1 or 2?
- Is their upper airway difficult or impossible to manage?
- This may be the very reason that they have a tracheostomy
- This information may determine whether you take out the tracheostomy tube or try to manipulate it in situ
- How old is the tracheostomy and how was it made?
This information can be shown on bedhead signs as shown on the next two pages.
Surgical tracheostomy
A surgical tracheostomy stoma is usually cut and stitched open and you are more likely to have an established stoma within a day or 2 (or even straight away) after a tracheostomy.
Surgical tracheostomy
A surgical tracheostomy stoma is usually cut and stitched open and you are more likely to have an established stoma within a day or 2 (or even straight away) after a tracheostomy.
Percutaneous tracheostomy
A percutaneous tracheostomy has been formed by stretching (dilating) the tissues which will spring back into their original places if the tube is removed. This risks losing the tract which doesn’t become established for the first 7-10 days after formation.
Each patient is different however and patient factors, different surgical and percutaneous approaches, the neck anatomy and the tube type all influence how long a stoma takes to become established. Percutaneously formed stomas do take longer to become established, and this makes changing a tube within the first 7-10 days after formation typically riskier than with a surgically created stoma.