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lunes, 16 de julio de 2018

Tracheostomy Emergencies

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emDocs - July 16, 2018 - Authors: Schwartz J., Lentz S., Roginski M. 
Edited by: Koyfman A and Long B
"Take Away Points
  • Differentiate simple tracheostomy versus total laryngectomy patients by ETCO2at the nose. 
  • Simple tracheostomy patients are (potentially) intubatable from the oropharynx. Total laryngectomy patients are not. 
  • Mucus plugging is common. Attempt suction and replace the tracheostomy tube’s inner cannula. 
  • Let down the cuff, if present, to reposition a tracheostomy tube. 
  • Use caution when replacing dislodged trach tubes in fresh tracheostomies. Consider orotracheal intubation instead. 
  • Bougie, Cook, and Aintree catheters can assist with tracheostomy tube exchange. 
  • Always confirm position of the exchanged tracheostomy tube by direct fiberoptic visualization or ETCO."