| A tracheotomy refers to a surgical incision into the anterior trachea, into which a tracheostomy tube is placed for protection of the airway. A tracheostomy is normally done in the Operating Room, but recent practice has shown a trend towards percutaneous tracheostomy at bedside in the Intensive Care Unit, using a Seldinger technique and serial dilators. After a horizontal incision in to the trachea below the cricoid cartilage is made, the thyroid gland is exposed and a vertical incision is then made between the second and third tracheal rings. When that incision has been made, the endotracheal tube cuff is deflated and the tracheostomy tube is inserted into the incision site immediately after the endotracheal tube is withdrawn. (3) After cuff inflation on the tracheostomy tube, the patient is ventilated with bag valve mask or mechanical ventilation. Sutures may be utilized to secure the tracheostomy tube, but it is normally stabilized adequately with tracheostomy tube ties. | | | | |
