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Surgery Lab Quiz > Tracheostomy > Flashcards

Flashcards in Tracheostomy Deck (18):
1

What is the treatment of upper airway obstruction expected to resolve with appropriate tx?

Temporary tracheostomy

2

What are diseases where a temporary tracheostomy is indicated?

Brachycephalic airway disease
Laryngeal paralysis
Mass causing obstruction
Oropharyngeal or laryngeal trauma

3

It is preferred that a patient is sedated for a temporary tracheostomy?

INTUBATED and ANESTHETIZED

4

T/F: You want the smallest size tube that can be easily accommodated by the trachea?

Largest size tube- sizes don't correspond to ET tube

5

What position should a patient be placed?

Dorsal recumbency w/ neck placed over rolled towel

6

What is the landmark for your incision?

caudal edge of cricoid (4-5 cm in length)

7

What are you dissecting in between and what instrument can be used to help you better visualize the area?

Strap muscles
Gelpi retractors aid in visualization

8

What type of incision is made in the trachea and in what rings?

Transverse interannular incision
between 3rd and 4th or 4th and 5th

9

What percentage of the trachea can be incised?

No more than 50%

10

What can be used for manipulating the trachea when changing tubes?

Stay sutures

11

How often should you be checking on your temporary trach patient?

Q4hr care w/ continuous monitoring

12

What can the tracheostomy site be cleaned with?

0.05% chlorhexidine

13

How long should you pre-oxygenate your patient for?

3-5 minutes

14

How often should the tube be replaced?

Q24 hrs.

15

What are some complications?

Tube occlusion
Airway suctioning
Vagally mediated bradycardia and collapse
Pneumomediastinum
Sx site infection
Coughing, gagging, vomiting
Aspiration pneumonia

16

How is the sx site healed?

Second intention
If you suture site it can result in subq emphysema that can progress to pneumomediastinum or pneumothorax

17

What is a diagnostic and therapeutic procedure that can be performed in patients in distress due to pleural effusion or pneumothorax?

Thoracocentesis

18

What are the intercostal spaces typically used for thoracocentesis?

6th, 7th and 8th intercostal spce
Effusion: costochondral junciton
Pneumothorax: dorsal