Small Animal Sx - Pulmonary Sx 2

drraythe's version from 2015-11-24 19:54

Tracheotomy and tube tracheostomy (DONT CALL IT AN ET TUBE)

Question Answer
why is there a metal spring in the T-tube?keep it from kinking (not all of them have the metal bit)
when do you do a Tracheotomy and tube tracheostomy?if need to bypass resp for a bit to let it rest
how do you go about sx preparing for placing the tube? (short+sweet w pics)place stay sutures to position tracheal tube. inision through membrane horizontally, or longitudinal splitting cartilage. Insert tube. gauze around tube w/ abx ointment and then tie around neck. cleaned daily.
specific way you go about inserting the T-tube? place stay suture (distal cart, sometimes prox) gonna leave stay suture long so can open trach when cleaning or removing tube and placing new one. so 2 better bc open easier. lift cat, introduce trach tube, inflate cuff, and then split gauze place at base of Ttube, with some abx cream, and then tie tube around the neck. needs to be cleaned on daily basis. coupage useful bc help get rid of mucus
how wide should you clip/what should the incision be like?clip wide-- distance of fingers in pic is about how long the incision should be
when making incision for T-tube placement... which structures must you be careful of? ventral vein on trachea, careful not to hurt thyroids, dont hurt recurrent laryngeal n
when making incision for T-tube placement.. size blade? how much of circumference to cut?incision 11-15 blade- dont go beyond 40% circumference of trachea or will cause more damage
what should you know about the stay sutures placed for this procedure?one on cr incision ring and one on ca incision ring. Thick suture, used for manipulating trach and opening. Can leave them in for later manipulation, tie around T-tube on outside
what should maintainance care be like for the T-tube?clean every day and flush it
what is this? what is it used for?this is quicktrack (respiratory catheter) curved needle. this special curved needle and on top, the cath thing thats curved and short. idea is w/o cutting or dissecting you can piercing with stylet, insert cath into trachea, pull out stylet, and then connect to breathing system to ventilate pt (quick track) ER way to access trach. (can make your own if you need to: 3cc syringe w/ old connector, take plunger out. and 16-18 g needle)
how do you perform a permanent tracheostomy?dissect trachea and remove small block of it. pass horizontal matress sutures from sternohyoidus and thyroidus-slide them underneath. bring mm against each other underneath trachea and push trachea upwards towards skin- preventing tension from sutures. will suture mucosa to the skin creating a permanent opening into the trachea. 3.5 -4 cm incisions-prevent shrinking. simple interrupted
*how big should you make your tracheostomy opening?3.5-4cm rule to acct for shrinking!!!
*If you are going to do a permanent tracheostomy on a dog, what rules should you lay down for the owners now?*CANT GO SWIMMING ANYMORE *buy bandana to protect form rocks and grass and such- keep fur trimmed and clean, clear mucus
3 ways to retrieve a tracheal FB?(1) Bronchoscopy and grasping equipment (2) Balloon catheter retrieval (3) Tracheotomy - rarely indicated
what kinda cellular damage can tracheal FB do?can cause necrosis and sloughing of mucosa- need to mainain ciliary and goblet system
what's that awful FB that can migrate through tissues and make your life horrible?grass awns