tracheostomy /trā′kē·os″təmē/ [Gk, tracheia + stoma, mouth] , an opening through the neck into the trachea through which an indwelling tube may be inserted. After tracheostomy the patient’s chest is auscultated for breath sounds indicative of bilateral air exchange and pulmonary congestion, mucous membranes and fingertips are observed for cyanosis, oxygenation is monitored with pulse oximeters, and humidified oxygen is given via a trach collar placed over the tracheostomy tube. The patient is reassured that the tube is open and that air can pass through it. The tube is suctioned as needed to keep it free from tracheobronchial secretions by using a suction catheter attached to a Y-connector. The catheter is rotated, and intermittent suction is applied for no longer than 10 seconds. Complications of tracheostomy include pneumothorax, respiratory insufficiency, obstruction of the tracheostomy tube or its displacement from the lumen of the trachea, pulmonary infection, atelectasis, tracheoesophageal fistula, hemorrhage, and mediastinal emphysema. If the procedure was done as an emergency, the tracheostomy is closed after normal breathing is restored. If the tracheostomy is permanent, such as with a laryngectomy, the patient is taught self-care. Compare tracheotomy.
