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Know the Tracheostomy Procedure, Indications and Risks

Tracheostomy is a procedure performed in emergency situations or in people with severe illness. The main purpose of this procedure is to maintain the airway. But in addition to its benefits, this procedure also carries the risk of complications, during or after a tracheostomy. Tracheostomy is also known as stoma. Health problems that require this procedure are generally related to the respiratory tract. With the aim of making sufferers can breathe properly. This procedure is usually performed in medical emergencies or in certain diseases that cause airway obstruction or respiratory failure. This condition is a serious condition that can be life threatening if not treated immediately, therefore tracheostomy is done to keep the breathing process going well to support the continuity of life.

Opening of the Throat

Tracheostomy is the opening or making of a hole performed on the windpipe or trachea, through an incision in the skin in the front of the neck, with the help of general anesthesia, to be made direct access to the breathing tube. In cases of emergency, general anesthesia is often not available, so the doctor will provide local anesthesia in the neck area to be dissected. After the anesthesia works, the doctor will begin dissecting the neck area under the Adam's apple and the surgical process is carried out up to the tracheal cartilage ring. After opening, the breathing tube will be installed in the hole. The breathing tube is then inserted into a hole made in the throat, just below the vocal cords. Then air will enter through the tube, into the lungs. The patient will then breathe through this tube, not through the nose or mouth. If needed, a breathing tube can be connected to an oxygen cylinder or ventilator machine. This hole can be temporary or permanent. The operation must be performed by a specialist.

Conditions that require tracheostomy

Some health conditions that require a tracheostomy procedure include:
  • Congenital or congenital respiratory tract disorders
  • Sores in the respiratory tract due to inhalation of corrosive materials
  • Chronic obstructive pulmonary disease (COPD)
  • Diaphragmatic dysfunction
  • Severe infection
  • Laryngeal / laryngectomy injury
  • Wound on the chest wall
  • Burns or major surgery on the face
  • Conditions that require prolonged breathing or ventilator assistance, such as paralysis.
  • Blockage of the respiratory tract by a foreign object or tumor.
  • Sleep apnea, due to a blockage in the airway.
  • Anaphylactic shock
  • Muscle paralysis used for swallowing
  • Coma
  • Severe mouth or neck injury
  • Paralysis of the vocal cords
  • Neck cancer
In addition to facilitating breathing, tracheostomy is also performed for the following reasons:
  • Create an alternative breathing path that surrounds or passes through blocked pathways so that oxygen can still reach the lungs
  • In order to more easily clean the respiratory tract and also as a drainage of fluid coming from the lungs.
  • As a liaison between the respiratory organs and mechanical breathing aids (ventilators) long-term.

Risk of Complications

Although leaving a small scar when the tube is removed (on a temporary tracheostomy), patients who go through this procedure are inseparable from the risk of tracheostomy complications that need to be watched out for, namely:
  • Damage to the thyroid gland in the neck
  • Scarring in the trachea
  • Lung leakage or malfunction
  • Infection
  • Bleeding
  • The air is trapped in the surrounding tissue or in the chest cavity.
  • Swallowing and vocal function disorders.
There are also some risks of complications that are less common, but still need to be aware of, such as damage to the larynx (vocal cords) or airways, and lead to changes in sound that are permanent and injury or erosion of the tissue around the respiratory tube. The doctor will usually adjust the tracheostomy procedure to the patient's condition and continue to monitor the results of the oximeter or ECG throughout the procedure. This procedure is indeed uncomfortable for the patient. In some cases after a pipe is attached to the trachea often the patient is difficult or even unable to speak or swallow, however indications of tracheostomy are aimed at preventing fatal complications from continuing. In addition to the conventional tracheostomy surgery, there are now less invasive breathing tube placement techniques through fatty tissue in the neck. However, tracheostomy through fatty tissue (percutaneous) is at high risk for complications in people with obesity, disorders of the neck and throat structure, children and thyroid enlargement. After a breathing tube has been attached to a hole made in the trachea, patients generally need three days before they become accustomed to having a breathing tube in their neck. For long-term users, the doctor will tell you how to treat and clean the breathing tube and do not forget to regularly check the condition according to the doctor's advice.

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