Tracheostomy dislodgement

Background

Tracheostomy Sizes

(1) Thyroid cartilage (2) Cricothyroid ligament (3) Cricoid cartilage (4) Trachea (A) Cricothyrotomy site (B) Tracheotomy site
Tracheotomy in situ
1 – Vocal folds
2 – Thyroid cartilage
3 – Cricoid cartilage
4 – Tracheal rings
5 – Balloon cuff
Shiley™ trach tube
  • Average size:
    • Adult: 5-10mm
    • Peds: 2.5-6.5mm

Tracheostomy vs laryngectomy

It is important to differentiate between tracheostomy vs laryngectomy

  • If laryngectomy[1]:
    • The stoma is the only way to ventilate the patient.
    • Patient cannot be orally intubated

Clinical Features

Differential Diagnosis

Tracheostomy complications

Evaluation

  • Determine whether tube is dislodged from the trachea, but not from the neck
    • Does a suction catheter pass without difficulty? If not, remove the tube

Management

  • If fresh tracheostomy, may be able to pull at stay sutures to bring airway anterior
  • BVM and look for bubbling at tracheostomy site

Disposition

See Also

External Links

References