Examination of Respiratory System — OmpathStudy

Continued from $1. 8.0 DIAGNOSTIC AND THERAPEUTIC PROCEDURES 8.1. Tracheostomy A tracheostomy is a surgical procedure where the surgeon creates an opening in the neck at the front of the windpipe (trachea). It is a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. This tube is called a tracheostomy tube or trach tube. A tube is inserted into the opening and connected to an oxygen supply to assist with breathing. Fluid that has built up in the throat and windpipe can also be removed through the opening. A tracheostomy can be performed as: an emergency procedure – for example, if someone is unable to breathe following an injury or accident a planned procedure – to help someone who can't breathe normally because of a long-term condition such as multiple sclerosis Indications A tracheostomy is usually performed: To deliver oxygen to the lungs when a person is unable to breathe normally – the loss of normal lung function is called respiratory failure (see below) To bypass an airway that has become blocked To remove fluid that has built up in the upper airway, particularly in the throat and windpipe (trachea) Respiratory failure There are many conditions that can lead to respiratory failure and the need for a tracheostomy. Examples are: Being unconscious or in a coma as a result of a severe head injury, drug overdose or accidental poisoning Brain damage caused by a stroke or a severe head injury paralysis (an inability to move one or more muscles) after a serious neck or spinal injury A condition that causes extensive damage to the lungs, such as pneumonia or cystic fibrosis (where the lungs become clogged up with mucus) A condition that causes progressive damage to the nervous system, such as motor neurone disease or guillain-barré syndrome (both conditions can lead to paralysis and breathing difficulties) Blockage The airways can become blocked due to: Accidentally swallowing something that gets stuck in the windpipe, such as a piece of bone An injury, infection, burns or a severe allergic reaction (anaphylaxis) that causes the throat to become swollen and narrowed A cancerous tumour that blocks one or more airways – this can sometimes happen with mouth cancer, laryngeal cancer or thyroid gland cancer In addition, some children are born with birth defects that cause one or more of their airways to be abnormally narrow. Fluid There are several factors that can cause fluid to build up inside the airways and lungs, resulting in breathing difficulties. There is also a danger that the fluid could become infected. In some circumstances, it may be necessary to carry out a tracheostomy so the fluid can be sucked out through the tracheostomy tube. This may be necessary when the person: Is unable to cough properly due to chronic pain, muscle weakness or paralysis Has a serious lung infection, such as pneumonia, that has caused their lungs to become clogged with fluid Has an injury that has resulted in their airways or lungs becoming filled with blood Risks The risks for any anesthesia are: 1. Problems breathing 2. Reactions to medications, including heart attack and stroke 3. The risks for any surgery are: 4. Bleeding 5. Infection 6. Nerve injury, including paralysis Other risks include: 1. Damage to the thyroid gland 2. Erosion of the trachea (rare) 3. Puncture of the lung and lung collapse 4. Scar tissue in the trachea that causes pain or trouble breathing Complications of a tracheostomy Having a tracheostomy is considered to be a safe and straightforward procedure, but as with many medical procedures it does carry a risk of complications.The likelihood of complications occurring will depend on your age and general health, and the reason why you need the tracheostomy. Generally, a planned tracheostomy carries a lower risk of complications than an emergency tracheostomy, and a percutaneous tracheostomy carries a lower risk than an open tracheostomy Early complications ✓ Occur during or shortly after a tracheostomy 1. Collapsed lung ✓ Sometimes, air will collect around the lungs and cause the lungs to collapse inwards. This is known as a pneumothorax. In mild cases this often corrects itself without the need for treatment. In more serious cases, a tube will need to be surgically implanted into the chest to drain the air away from the lungs 2. Accidental injury ✓ The nerves near the windpipe can be accidentally damaged, such as those controlling the voicebox (larynx) or the oesophagus (tube that runs from the back of the throat to the stomach). This may cause problems with speaking and swallowing 3. Infection ✓ The windpipe or nearby tissues can become infected with bacteria. These usually need to be treated with antibiotic injections. Late complications ✓ Occur days, weeks or even months after a tracheostomy 1. Failure to heal ✓ Sometimes, the tracheostomy wound will not heal pro