Anesthesia 5th year, 5th lecture (Dr. Gona)

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College of Medicine, Sulaymaniyah

The lecture has been given on Nov. 30th, 2010 by Dr. Gona.

Health & Medicine

Cricothyrotomy ,[object Object],[object Object]

Tracheostomy ,[object Object],[object Object],Uses for a tracheotomy The conditions in which a tracheotomy may be used are: Acute setting - maxillofacial injuries, large tumors of the head and neck, congenital tumors, e.g. branchial cyst , acute inflammation of head and neck, and Chronic / elective setting - when there is need for long term mechanical ventilation and tracheal toilet, e.g. comatose patients, surgery to the head and neck.

Uses for a tracheotomy ,[object Object],[object Object],[object Object]

Completed tracheotomy : 1 - Vocal cords 2 - Thyroid cartilage 3 - Cricoid cartilage 4 - Tracheal cartilages 5 - Balloon cuff

Complications: ,[object Object],[object Object]

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Surgical Management Of the Failed Airway: A guide to precutaneous cricothyrotomy Guidelines from Hoan E. Spiegel, MD Assistant Professor Beth Israel Ddeaconess Medical Center Harvard medical School Boston, MS Vipul Shah, MD Western Washington Medical Group Everett, Washington The first-known mention of an attempted surgical airway, a tracheostomy, was depicted on Egyptian tablets as early as 3600 BCE. History has condemned the emergent surgical airway when it has failed, but when successful, the physicians who performed it have risen in esteem to become "on a footing with the gods". Il 100 BCE, the Persian physician Asclepiades described in detail a tracheal incision for improving the airway. Yet most who advocated surgical approaches to the airway, including Asclepiades, were severely criticized. Vicq d'Azyr, a French surgeon and anatomist, first described cricothyrotomy in 1805. Emergent cricothyroidotomy /also known as cricothyrotomy, minitracheostomy, and high tracheostomy) became widely acknowledged and accepted in 1976 when Brantigan and Grow confirmed the relative safety of the procedure. A decade later, the Seldinger technique, a wire-over-needle procedure commonly used for intra-vascular cannulation, was adapted for use in obtaining both emergent and nonemergent surgical airways.

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