# Tracheostomy Resuscitation



## Charlie (Sep 11, 2009)

How many people have had to do this in the field?


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## Akulahawk (Sep 11, 2009)

You mean provide breathing assistance via already placed Trach tube? I know how to... but I've never had to do it in the field. I've had to bag patients during portions of IFTs... but never on a scene call.


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## VentMedic (Sep 11, 2009)

Or as in tracheostomy with an open stoma?


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## Akulahawk (Sep 11, 2009)

Every person I've ever encountered who had an open stoma... never needed assistance in breathing. I do know how to use a BVM with an open stoma... but it's not something I've had to do. I tend to be a "white cloud" for certain types of calls. That's one of them.


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## VentMedic (Sep 11, 2009)

Tracheotomy is where there is just an incision in the trachea for an artificial airway such as a trach. There is still communication to the upper airway and one could bag or intubate orally if you were unable to insert another airway. This hole will close very quickly within a few minutes to days of the trach removable. 







Patients with trachs may also have one of these attached for speaking which can be removed for access to the trach.





Below is a tracheostomy. The trachea is brought externally to create a permanent opening much like a colostomy. There is NO communication with the upper airway. If one did not have a tube to place in the opening, one could use the mask from an infant or pedi BVM with an adult (if it is an adult) BVM. This procedure is common for throat cancer patients. Also, if a patient is found down you may not immediately recognize this stoma unless you visualize the neck. Some will wear a flesh colored covering that keeps stuff out and self humidifies the air. Some may also have a Blom-Singer valve for speaking in place between the esophagus and trachea that can become dislodged. 
http://www.inhealth.com/pdf/literature/catalogs/Blom-Singer_HME_System_Brochure_web.pdf


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## Charlie (Sep 11, 2009)

I though this may be more common in Long-Term Care facilities. I am still in First Responder class  so my questions may be a little vague  ..it was just something that was not even in my realm of thought until today


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## VentMedic (Sep 11, 2009)

Charlie said:


> I though this may be more common in Long-Term Care facilities. I am still in First Responder class so my questions may be a little vague ..it was just something that was not even in my realm of thought until today


 
No. Patients with stomas can be anywhere and everywhere and you may never know it unless you have the highly trained eyes and ears of a Respiratory Therapist.

The same with trachs. Although there are huge sub-acute facilities with over a hundred trachs under one roof. 

Kids (and babies) can also have tracheotomies and tracheostomies. Usually the parents or caregivers will show you everything you need to know.


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## Hal9000 (Sep 11, 2009)

I've done CPR on a person that went into a gravelly body of water and ended up with everything going in.  I did not enjoy it overly much.


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## amberdt03 (Sep 11, 2009)

VentMedic said:


> Tracheotomy is where there is just an incision in the trachea for an artificial airway such as a trach. There is still communication to the upper airway and one could bag or intubate orally if you were unable to insert another airway. This hole will close very quickly within a few minutes to days of the trach removable.
> 
> 
> 
> ...



thanks for the great diagrams and info!!!


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