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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The second tracheal ring is opened with an 11 or 15 blade. The incision shown creates an inferiorly based flap. Some surgeons favor a cruciate incision.
A D V E R T I S E M E N T
The flap is reflected caudally and sutured to fascia above the sternal notch. this creates a smooth ramp for inserting the tracheostomy tube initially and later if it needs to be replaced. Patients requiring tracheostomy are usually intubated and the endotracheal tube is exposed when the cartilaginous flap is turned down.
Notes:
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A D V E R T I S E M E N T
The trach tube balloon is tested for integrity, the lower edge of the cricoid cartilage is elevated with a tracheal hook, the endotracheal tube cuff is deflated and the tube is slowly withdrawn until the tip is visible in the stoma. The tracheostomy tube is carefully inserted, the airway tubing connected, and the balloon inflated. the skin incision is closed beneath the crosspiece and the wings of the crosspiece are tied snugly around the neck using umbilical tape.
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This page was last modified on 2/7/1999.
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