Tracheostomies
A tracheostomy is an opening in the anterior wall of the trachea to
facilitate ventilation. It is sited below the level of the vocal cords.
Indications
● Provide and maintain a patent airway when the upper airways are
obstructed.
● Provide access for the removal of tracheobronchial secretions.
● Prevent aspiration of oral and gastric secretions in patients unable to
protect their own airway.
● Used in patients who need longer-term ventilation.
Types of tube
Metal or plastic
● Metal tubes are used by long-term tracheostomy patients as they are
more durable. They are made of either stain- less steel or sterling silver
and do not have connections for respiratory equipment, e.g. a
resuscitation bag. On some tubes an adaptor can be attached.
● Plastic tubes are cheaper and therefore more disposable.
Cuffed or uncuffed
● Cuffed tubes have an air-filled sac at their distal end. When inflated a
cuffed tube provides a seal between the trachea and the tube. It
protects the airway against aspiration and allows positive pressure
ventilation. Patients cannot speak when the cuff is inflated, unless the
tube is fenestrated.
● Uncuffed tubes are used for pediatric patients as the air space around
the tube can be sealed without the need for a cuff. Also used when the
cuff is no longer required for ventilation, when there is no risk of
A tracheostomy is an opening in the anterior wall of the trachea to
facilitate ventilation. It is sited below the level of the vocal cords.
Indications
● Provide and maintain a patent airway when the upper airways are
obstructed.
● Provide access for the removal of tracheobronchial secretions.
● Prevent aspiration of oral and gastric secretions in patients unable to
protect their own airway.
● Used in patients who need longer-term ventilation.
Types of tube
Metal or plastic
● Metal tubes are used by long-term tracheostomy patients as they are
more durable. They are made of either stain- less steel or sterling silver
and do not have connections for respiratory equipment, e.g. a
resuscitation bag. On some tubes an adaptor can be attached.
● Plastic tubes are cheaper and therefore more disposable.
Cuffed or uncuffed
● Cuffed tubes have an air-filled sac at their distal end. When inflated a
cuffed tube provides a seal between the trachea and the tube. It
protects the airway against aspiration and allows positive pressure
ventilation. Patients cannot speak when the cuff is inflated, unless the
tube is fenestrated.
● Uncuffed tubes are used for pediatric patients as the air space around
the tube can be sealed without the need for a cuff. Also used when the
cuff is no longer required for ventilation, when there is no risk of
