• This article discusses the procedure of tracheostomy – whereby an opening is created into the trachea, with insertion of an indwelling tube.
  • A tracheotomy refers to incision of the trachea for exploration, sample collection or foreign body removal.
• Tracheostomy is an emergency procedure to relieve acute upper respiratory tract obstruction.
• Permanent tracheostomies can be performed where there is permanent impairment of upper airway flow.

Uses

Emergency

• Acute obstruction of upper respiratory tract.
• Accidental intra-tracheal bolus placement Farmer information sheet on bolus technique
• Acute reactions to bites/Stings Stings.
• Traumatic/infectious pharyngitis.

Chronic conditions

• Neoplasia.
• Laryngeal paralysis.
• Laryngeal edema Diseases and disorders of the larynx: an overview.
• Arytenoid chondritis Diseases and disorders of the larynx: an overview.
• Necrotic laryngobacillosis (calf diptheria) Diseases and disorders of the larynx: an overview.
• Hematoma from jugular venepuncture in a calf.

Advantages

• Can be performed standing.
• Relatively simple surgery.
• Cheap.

Disadvantages

• Wound infections common (especially in emergency situation without aseptic technique).
• Some aftercare required.
• Long term damage to tracheal cartilages.
• Compromised respiratory defence mechanisms; may lead to bronchopneumonia.
• Frequent monitoring and cleaning of tube in the acute phase after performing procedure.

Technical problems

• Appropriately sized tubes should be used.
• Self-retaining tubes are easier to manage.

Time required

Preparation

• Restraint, clipping, Local anesthesia Local anesthesia and aseptic preparation (15-20 minutes).
• Sedation Sedation can be used but may lead to cardiorespiratory collapse in an animal with respiratory compromise.
• Emergency < 5 minutes.

Procedure

• Routine when tube is placed (30 minutes).
• Emergency (5-10 minutes).

Decision taking

Criteria for choosing test

• Temporary technique used in emergency situations or where an alternative anesthetic route is required.
• Long term/permanent technique can be used as a salvage procedure.

Risk assessment

• May lead to upper respiratory tract obstruction.
• Post-surgical wound infections are common.