TRACHEOSTOMY TUBES

TRACHEOSTOMY TUBES

TYPES OF TRACHEOSTOMY TUBE

  • A tracheostomy tube may be metallic or nonmetallic

Metallic Tracheostomy Tube

  • Metallic tubes are formed from the alloy of silver, copper and phosphorus
  • Example Jackson’s Tracheostomy tube.
  • Has an inner and an outer tube.The inner tube is longer than the outer one so that secretions and crusts formed in it can be removed and the tube reinserted after cleaning without difficulty. However, they do not have a cuff and cannot produce an airtight seal.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.
  • Inner cannula should be removed and cleaned as and when indicated for the first 3 days. Outer tube, unless blocked or displaced, should not be removed for 3-4 days to allow a track to be formed when tube placement will be easy.

Nonmetallic Tracheostomy Tube

  • Can be of cuffed or noncuffed variety, e.g. rubber and PVC tubes.

Cuffed Tracheostomy Tubes

  • Pediatric tubes do not have a cuff.
  • Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).
  • The cuff should be deflated every 2 hours for 5 mins to present pressure damage to the trachea.

Uncuffed Tracheostomy Tubes

  • It is suitable for a patient who has returned to the ward from a prolonged stay in intensive care and requires physiotherapy and suction via trachea.
  • This type of tube is not suitable for patients who are unable to swallow due to incompetent laryngeal reflexes, and aspiration of oral or gastric con­tents is likely to occur.
  • An uncuffed tube is advantageous in that it allows the patient to breathe around it in the event of the tube becoming blocked. Patients can also speak with an uncuffed tube.

Important

Nonmetallic Tracheostomy Tube - Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).

Metallic Tracheostomy Tube -Metallic tubes are formed from the alloy of silver, copper and phosphorus .

  • Example Jackson’s Tracheostomy tube.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.

Related Questions HEAD , NECK & SPINE

Predisposing factors

Pipe smoking
Syphilis
Chronic superficial glossitis
Alcohol
Chronic irritation -sharp tooth
Betel nuts

Macroscopically

Ulcer –most common
irregular margins evertededges

Warty growth

Induratedgrowth or mass

Fissure

Clinical features

Usually age > 50 yrs

Sex both equally

Painless lump or ulcer on tongue

Excessive salivation

Foetororis

Ankyloglossia-immobility of tongue

Pain –involvement of nerve

Horsenessof voice & dysphagiain posterior 3rd tongue

Lump in neck

Examination

Site -common anterior 2/3 near edges

Ulcer papilliferoursor  warty, lump fissure

Palpation of posterior 2/3 tongue

Largngoscopy

Examination of lymph node
Submental
Submandibular
Jugulodiagastric

Diagnostic

Biopsy : margin or excision biopsy

FNAC lymphnodes

Ultrasound deep LN

CT scan bone invasion & mets

MRI for oral cavity oropharynx

Radionucleotidescan

TYPES OF TRACHEOSTOMY TUBE

  • A tracheostomy tube may be metallic or nonmetallic

Metallic Tracheostomy Tube

  • Metallic tubes are formed from the alloy of silver, copper and phosphorus
  • Example Jackson’s Tracheostomy tube.
  • Has an inner and an outer tube.The inner tube is longer than the outer one so that secretions and crusts formed in it can be removed and the tube reinserted after cleaning without difficulty. However, they do not have a cuff and cannot produce an airtight seal.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.
  • Inner cannula should be removed and cleaned as and when indicated for the first 3 days. Outer tube, unless blocked or displaced, should not be removed for 3-4 days to allow a track to be formed when tube placement will be easy.

Nonmetallic Tracheostomy Tube

  • Can be of cuffed or noncuffed variety, e.g. rubber and PVC tubes.

Cuffed Tracheostomy Tubes

  • Pediatric tubes do not have a cuff.
  • Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).
  • The cuff should be deflated every 2 hours for 5 mins to present pressure damage to the trachea.

Uncuffed Tracheostomy Tubes

  • It is suitable for a patient who has returned to the ward from a prolonged stay in intensive care and requires physiotherapy and suction via trachea.
  • This type of tube is not suitable for patients who are unable to swallow due to incompetent laryngeal reflexes, and aspiration of oral or gastric con­tents is likely to occur.
  • An uncuffed tube is advantageous in that it allows the patient to breathe around it in the event of the tube becoming blocked. Patients can also speak with an uncuffed tube.

Important

Nonmetallic Tracheostomy Tube - Cuffed tubes are used in situation where positive pressure ventilation is required, or when the airway is at risk from aspiration. (In unconscious patient or when patient is on respiration).

Metallic Tracheostomy Tube -Metallic tubes are formed from the alloy of silver, copper and phosphorus .

  • Example Jackson’s Tracheostomy tube.
  • Advantages of a double lumen tracheostomy tube are easy to remove,clean and replace inner cannula.