Tracheostomy

Tracheostomy

اسلاید 1: Tracheostomy

اسلاید 2: Why, when, and how?There is evidence that tracheostomy was first performed as long ago as 2000 BC, although the first clearly documented tracheostomy was in the 15th century.In the last 60 yr, percutaneous tracheostomy methods have been developedIn the case of an elective tracheostomy procedure performed in the intensive care unit, there remains debate about the timing of insertionCurrent evidence suggests that there are no significant differences in critical care or hospital length of stay associated with an early (<10 days) vs a late (>10 days) tracheostomy procedure, although the number of sedation days is reduced inpatients in whom an early tracheostomy is performed.

اسلاید 3: Why, when, and how?For patients who are unable to wean from invasive ventilation within one to three weeks of intubation, tracheostomy and transfer to a long-term assisted care (LTAC) facility is often considered. There is no optimal time for this transition with practice-pattern variation among physicians. The decision should be individualized according to the clinical circumstances and the patients preference such that daily assessment of a patients progress, readiness to wean, and need for tracheostomy is warranted.

اسلاید 4:

اسلاید 5: Indications for tracheostomy

اسلاید 6: Types of tracheostomy tubeCuffed and uncuffedFenestrated and unfenestratedSingle and double lumenVarious diameters

اسلاید 7: cuffsTo protect airwayTo allow ventilation

اسلاید 8: fenestrationsAllow patient to ventilate past tube via upper airwayAllow speech