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TIF is a late complication of a tracheotomy and is associated with prolonged endotracheal intubation, as a result of cuff over inflation or a poorly positioned tracheostomy tube. [1] [4] Over inflation of the cuff causes the tracheostomy tube to erode into the posterior aspect of the innominate artery leading to the formation of a fistula. [2]
A tracheostomy tube may be single or dual lumen, and also cuffed or uncuffed. A dual lumen tracheostomy tube consists of an outer cannula or main shaft, an inner cannula, and an obturator. The obturator is used when inserting the tracheostomy tube to guide the placement of the outer cannula and is removed once the outer cannula is in place.
The cuffs are high-volume, low-pressure cuffs with inflating volume ranging from 10 ml (size 0) to 90 ml (size 5). A large bore syringe, which is marked with the required volume for each size, is used to inflate the cuffs. A cuff inflator can also be used, in which case the cuffs should be inflated to a pressure of 60 cm H2O.
A tracheotome is a medical instrument used to perform an incision in the trachea with a cutting blade operated by a powered cannula. It is often called a tracheostomy tube because once it enters the stoma in the trachea, a breathing tube is connected to a ventilator and oxygen is provided to the lungs.
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 ...
A tracheostomy tube is another type of tracheal tube; this 50–75-millimetre-long (2.0–3.0 in) curved metal or plastic tube may be inserted into a tracheostomy stoma (following a tracheotomy) to maintain a patent lumen.
A tracheostomy tube or endotracheal tube with a 6 or 7 mm internal diameter is then inserted, the cuff is inflated, and the tube is secured. The person performing the procedure might utilize a bougie device, a semi-rigid, straight piece of plastic with a 25-mm tip at a 30-degree angle, to provide rigidity to the tube and assist with guiding its ...
For an inflatable cuff, the cuff should be inflated and deflated outside the patient to ensure it is functional. [1] A pen-like grip is used to move it through the patient's mouth and throat, preferably when their head is extended to straighten the airway. [1] The laryngeal mask airway should be lubricated so that it can be placed more easily. [1]
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