Tracheostomy is a surgical procedure performed to create a hole in the front area of the neck into the windpipe. Then a tracheostomy tube is placed in this hole to keep it open for breathing. It provides a passage for breathing when the normal route of breathing gets blocked. A tracheostomy is performed when a health problem requires long-term breathing support from a machine or after a traumatic injury to the face or the neck.
When the tracheostomy is no longer needed, it is either left to heal naturally. It may be temporary or permanent.
Parts of a tracheostomy tube include:
The part of the tube protrudes out of the patient’s neck. It has a universal diameter of 15mm so that it can connect with the ventilator circuit, resuscitation bags, speaking valves, and caps. Hence, any tracheostomy tube with a hub can fit these devices easily.
Some manufacturers keep the hub color-coded, so it is easier to identify tracheostomy tube sizes.
An outer cannula is the main part of the tracheostomy tube and is inserted into the trachea. It can be fenestrated, non-fenestrated, cuffed, or uncuffed. It comes in different sizes. Generally, the size of the cannula is shown on the flange as the outer diameter, which is the distance between the outside walls of the outer cannula and measured in millimeters.
It is a part of the tube that extends from the outer area of the tube. It should lie flush against the skin of the neck. The neckplate extends from both sides of the outer cannula and has holes to tie a strap around the neck.
It has important information regarding the tracheostomy tube size, outer diameter, inner diameter, and cuff type.
Tube tie keeps the tube in place and prevents accidental decannulation. It attaches to the flange through the side holes and wraps around the patient’s neck.
One finger should be used to see if the tie is tight enough to prevent dislodgement. It should be noted that the edges may cause ulcerations if the tie is too tight. These ties should not be used if the patient recently had major neck surgery.
An inner cannula fits inside the outer cannula and prevents obstruction. It can be easily removed or replaced for cleaning.
The size of the inner cannula should first be matched with the outer cannula to obtain a proper fit. Although the inner cannula comes packed with the tracheostomy tube, if required, it is available separately also.
Some manufacturers keep them color-coded to identify the corresponding hub of the tracheostomy tube.
An obturator, also known as the pilot, guides the tracheostomy tube when inserted into the air passage. The inner cannula is removed, and the obturator is inserted, which extends a little beyond the tracheostomy tube.
It has a blunt tip to avoid damage to the inner tissues. Soon after placement, the obturator is removed and replaced with an inner cannula.
There are three types of tracheostomy tubes -
The location of the fenestration is important. If it is closer to the tracheal wall, it may cause the proliferation of scar tissue. This scar tissue reduces the effectiveness of the openings, makes it difficult to pass a suction catheter, and complicates the removal of the inner cannula.
While inserting and removing a tracheostomy tube into the stoma, extreme care should be taken. A dislodged tracheostomy tube could lead to complications. If the tube is not going inside, it should not be forced. Instead, try with a smaller tube or try re-inserting the old tube. During removal, ensure that the patient is relaxed and comfortable and does not hurt while removing the tube.
HPFY hosts a wide variety of different types of tracheostomy tubes. Some of our bestsellers are:
Designed for use with spontaneously breathing patients. It can bypass upper airway obstruction, provide long-term ventilation, and manage tracheal secretions.
Offers patient comfort and allows easy inspection of the stoma site. This inner cannula is secured with a unique twist-lock mechanism that makes it easy to use by patients and healthcare workers.
Designed for pulmonary hygiene, this fenestrated tube directs breathing through the upper airway. It has an integral 15mm twist-lock connector and a high-volume, low-pressure cuff that reduces the risk of tracheal damage.
Tracheostomy tube sizes differ from brand to brand.
Note: The outer diameter of the tracheostomy tube must be about two third to three fourth of the tracheal diameter. As a common rule, most adult females can accommodate a tube of 10 mm outer diameter, whereas most adult males require a tube of 11mm outer diameter.
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Akanksha Nigam has been a Health Products For You contributor since 2021. With a Masters Degree in Finance, she began her Marketing career in the banking industry. However, her interest in human ...
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