title: The technique of tracheotomy and cricothyroidotomy. When to operate--and how to manage complications.
abstract: Tracheotomy can relieve upper airway obstruction, improve pulmonary hygiene, and support long-term mechanical ventilation. Consider performing a tracheotomy whenever the need for more than 14 days of ventilatory support is anticipated. When emergent airway access is needed and translaryngeal intubation is not possible, consider cricothyroidotomy. For a tracheotomy, make a transverse incision 1 cm above the suprasternal notch or, for cricothyroidotomy, through the superficial cricothyroid membrane. Accidental tube displacement within 5 days of surgery is potentially tracheotomy's most lethal early complication. Many late complications can be prevented by careful management and expert nursing support.
authors.affiliation: St. Joseph's Hospital and Medical Center in Phoenix, Arizona, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Heffner
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D000075202:Contraindications; D003413:Cricoid Cartilage / Q000601:surgery*; D006801:Humans; D012121:Respiration, Artificial; D013997:Time Factors; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*