Tracheotomy
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Acute Stenosis Of The Larynx
Etiology.--Causes of a relatively sudden narrowing of the lumen of the larynx and subjacent trachea are included in the following list. Two or more may be combined. 1. Foreign body. 2. Accumulation of secretions or exudate in the lumen. 3. D... Anesthesia
No dyspneic patient should be given a general anesthetic; because any patient dyspneic enough to need a tracheotomy for dyspnea is depending largely upon the action of the accessory respiratory muscles. When this action is stopped by beginning unco... Bronchial Aspiration
As mentioned above, bronchial aspiration is often necessary. When the patient is unable to get up secretions, he will, as demonstrated by the author many years ago, drown in his own secretions. In some cases bronchoscopic aspiration is required (Pe... Decannulation
When the tracheal incision is placed below the first ring, no difficulty in decannulation should result from the operation per se. When by temporarily occluding the cannula with the finger it is evident that the laryngeal aperture has regained suffi... Emergency Tracheotomy
Stabbing of the cricothyroid membrane, or an attempted stabbing of the trachea, so long taught as an emergency tracheotomy, is a mistake. The author's two stage, finger guided method is safer, quicker, more efficient, and not likely to be followed ... Resume Of After-care Of A Tracheotomic Case
1. Always bear in mind that tracheotomy is not an ultimate object. The ultimate object is to pipe air down into the lungs. Tracheotomy is only a means to that end. 2. Sterile tray beside bed should contain duplicate (exact) tracheotomy tube, Tr... Resume Of Emergency Tracheotomy
The following notes should be memorized. 1. Essentials: Knife and pair of hands (but full equipment better). [295] 2. Don't do a laryngotomy, or stabbing. 3. Two stage, finger guided operation better. 4. Sand bag or substitute. 5. Press ... Resume Of Tracheotomy
Instruments. Headlight Sandbag Scalpel Hemostats Small retractors Tenaculum Tracheotomic cannulae (proper kind) Long. Half area cross-section trachea. Proper curve: Radius too short will press ant. tracheal wall; too... Technic
The patient should be placed in the recumbent position, with the extended head held in the midline by an assistant. The shoulders, not the neck, should be slightly raised with a sand bag. The head should be somewhat lower than the feet, to lessen th... Tracheotomy
Indications.--Tracheotomy is indicated in dyspnea of laryngotracheal origin. The cardinal signs of this form of dyspnea are: 1. Indrawing at the suprasternal notch. 2. Indrawing around the clavicles. 3. Indrawing of the intercostal spaces. ...