The Intern At Work: Internal Medicine 261. Trach 102 - An Approach to Tracheostomy Associated Emergencies
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Dec 2, 2024 Explore how to handle tracheostomy emergencies with expert insights. The discussion delves into essential management strategies through real-life clinical case studies. Discover critical steps for diagnosing and mitigating complications. Learn how to ensure patient safety during these urgent scenarios and gain valuable knowledge for navigating high-stress situations in healthcare.
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Urgent Tube Replacement After Decannulation
- Replace a dislodged tracheostomy tube urgently, especially within the first week.
- Use fiber optic endoscopy to avoid false passage or consider oral intubation if replacement fails.
Clear Obstruction with Suctioning First
- Remove speaking valves, obturators, and inner cannulas and attempt suctioning to relieve tracheostomy obstruction.
- If suction catheter won't pass, suspect complete obstruction and get urgent bronchoscopic evaluation.
Understanding Tracheal Stenosis Timing
- Tracheal stenosis often presents late when lumen diameter is reduced over 50%.
- Symptoms occur mostly within two months after decannulation but can happen anytime after prolonged intubation.