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Tracheotomy (/ ˌ t r eɪ k i ˈ ɒ t ə m i /, UK also / ˌ t r æ k i-/), or tracheostomy, is a surgical airway management procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the trachea (windpipe).
In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
In its basic (standard) version, the laryngeal tube is made up of a tube with a larger balloon cuff in the middle (oropharyngeal cuff) and a smaller balloon cuff at the end (oesophageal cuff). The tube is kinked at an angle of 30-45° in the middle; the kink is located in the larger cuff.
Intubation (sometimes entubation) is a medical procedure involving the insertion of a tube into the body. Patients are generally anesthetized beforehand. Examples include tracheal intubation , and the balloon tamponade with a Sengstaken–Blakemore tube (a tube into the gastrointestinal tract ).
Intubation with a cuffed tube is thought to provide the best protection against aspiration. Downside of tracheal tubes is the pain and coughing that follows. Therefore, unless a patient is unconscious or anesthetized, sedative drugs are usually given to provide tolerance of the tube.
Ivan Magill later added a cuff (these were glued on by hand to make the famous Blue-line tube copied by many other manufacturers). Maeterlinck GmbH developed the disposable endotracheal tube and produced many design variations, adding the 'Murphy Eye' to their tubes in case of 'accidental' placement of the tube to avoid right bronchial occlusion.
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Age can play a role in whether or not the procedure is warranted, and is commonly needed in younger persons. [40] The clinician that performs Rapid Sequence Induction and Intubation (RSII) must be skilled in tracheal intubation and also in bag valve mask ventilation. Alternative airway management devices must be immediately available, in the ...
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