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Tracheostomy management

A basic understanding is essential for dealing with emergency blockages and displacements

  • By: Andrew Cumpstey, Stuart J Benzie, Stuart McKechnie
  • Published: 16 October 2012
  • DOI: 10.1136/sbmj.e6016
  • Cite this as: Student BMJ 2012;20:e6016

A tracheostomy (or tracheotomy) is a direct opening in the anterior trachea communicating with a stoma on the surface of the neck. This allows air to pass directly into the trachea below the vocal cords (fig 1). Different forms of this operation have been carried out for over 3000 years, by Alexander the Great and Galen among others.1 The procedure is common in modern medical practice, and doctors are likely to encounter patients with tracheostomies in the early years of their training.2 Junior doctors might find themselves having to manage patients with emergency tracheostomies.

A basic knowledge of tracheostomies is therefore essential for all medical practitioners, together with an understanding of how to respond to common life threatening complications related to tracheostomies, particularly displacement and obstruction of the tracheostomy tube.3

This article outlines the main indications for tracheostomy and the different types of tracheostomy tube in widespread use. The initial

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