Tracheostomy
          
          Definition
          
          A surgical opening in the trachea which bypasses the nose and mouth
          
          
            - Vertical or horizontal incision in the trachea
 
            - Stay sutures placed near the end of the incised tracheal ring post operatively
 
            - Stoma is the opening of the tracheostomy. The tract is usually established and healed in about 5 days
 
            - Stoma kept open with a tracheostomy tube
 
          
         
        
          
            
              
                
              
              
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                      - to bypass airway obstruction
 
                      - manage chronic aspiration
 
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                       allow for long term ventilation
                        
 
                       
                     
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            - Stay sutures taped to the child's chest to aid placement of the trach tube if decannulation occurs before the first tube change.
 
            - Trach ties are not changed post operatively until ordered by the surgeon.
 
            - The first trach tube change is done by the surgeon five to seven days after surgery.
 
          
          
            
            
            Image retrieved from Great Ormond Street Hospital for Children Living with a Tracheostomy