Talk:Tracheotomy

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 26 November 2018 and 21 December 2018. Further details are available on the course page. Student editor(s): Kwanster8. Peer reviewers: Ucsfwikielective2018.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 11:34, 17 January 2022 (UTC)

How to perform a tracheotomy
I was curious as to why this was placed in the tracheotomy article. I understand this would have a great deal of value to medical professionals, but the average person? How often do non medical people have to perform an emergency tracheotomy? And if that's what the instructions are geared towards, the section might be too technical? Take for example step #3 "Division of thyroid isthmus between ligatures". Most people would have no idea what that is, I have no idea what step #3 means.

JesseG 01:32, Feb 25, 2005 (UTC)


 * Because it is interesting and relevant. Even if it doesn't give you an exact idea, you still get a general idea. Don&#39;t give an Ameriflag 01:53, 24 March 2006 (UTC)

Name
"Tracheotomy"/"tracheostomy"? Ground 02:41, 25 Feb 2005 (UTC)
 * Essentially synonyms. Tracheotomy is "cutting into the trachea", tracheostomy is "making an opening into the trachea". I suppose the former might be used more in emergency settings, and the latter in elective settings, but basically there's not much of a distinction. - Nunh-huh 04:53, 25 Feb 2005 (UTC)

well i found the info helpfull, i had this done to me november 2005 after giving birth to my son. im alittle disapointed that it says nothing of the after effects, i now suffer with my throut, its sore to swallow now and then, and ive been left with a terrible scar, no one at the hospital told me how it worked or anything, they couldnt even tell me why i was unable to talk, or make any sound for that matter, never mind, i guess ill keep looking around for my answeres.


 * Nunh-huh (or someone else knowlegeable) could you please add to the article intro something about emergency settings versus elective settings? -Pgan002 05:34, 5 November 2007 (UTC)

Confusion
The article states that tracheotomy is a surgical procedure and later in the second paragraph talks about the "indiacations" of it. Is it the name of a medical condition also? -- Sundar 04:42, Feb 25, 2005 (UTC)
 * An "indication" for a surgical procedure is a reason for doing it. I've translated it into English from "medical" now. -Nunh-huh

Fine. Thanks. -- Sundar 05:21, Feb 25, 2005 (UTC)

Loss of speech...
During the procedure, there is a risk of damaging a nerve called (I have to write in Latin, because we use it in medicine in my country) NERVUS LARYNGEUS RECCURENS. This nerve sends impulses (alows the function) of VOCAL CORDS. If one of the nerves, and there are two of them: n. laryngeus reccurens sinister et dexter, is damaged, a person will probably have a problem with their voice (as if you were singing all night, or have a bad cold). But if both of the nerves are damaged, the person would loose their speech. It is possible that the loss of speech is just temorary, because of the procedure...

I hope this has been helpful.

Stefan

I have had loss of speech after the tracheotomy and also mix up my words and can't pronounce them. — Preceding unsigned comment added by 71.125.23.96 (talk) 04:01, 7 May 2014 (UTC)


 * Most anatomists/doctors under the age of 70 wouldn't use the latin name, they would call it "recurrent laryngeal nerve", so called because they loop down around some major blood vessels and recurr back up to the larynx. Likewise, they would say "left" instead of "sinister" and "right" instead of "dexter". This risk of nerve damage is the reason emergency tracheotomies are performed higher up, in the larynx and why tracheostomies have to be done in hospital under anaesthetic as i have mentioned below.--KX36 22:12, 11 December 2006 (UTC)


 * But in the illustration, the vocal folds are way up at the top, with the tracheotomy below. —Preceding unsigned comment added by 75.73.70.113 (talk) 23:50, 8 March 2011 (UTC)

Tracheo-oesophageal fistulation
Tracheo-oesophageal fistulation is a late comlication. The term fistula implies the development of an epithelialised tract between two surfaces. What i presume you are referring to is accidental puncture of the oesophagus which would indeed be an early complication.

Also with regard to the -otomy/-ostomy debate, tracheotomy would simply refer to a cut, tracheostomy is the creation of a stoma (Greek for mouth) which is more appropriate in this setting. But that could just be me being a pedant.

Euan Green


 * A fistula is a pathological hole, so a tracheo-oesophageal fistula would be a pathological hole joining the trachea and the oesophagus. I can find no reference in medical dictionaries or my textbooks which says it necessarily must be "epithelialised".--KX36 22:29, 11 December 2006 (UTC)

Tracheotomy vs Tracheostomy
They are NOT the same thing. They are both openings in the upper respiratory tract to allow breathing to continue when there is a blockage higher up, however...

A TRACHEOTOMY is a temporary tube inserted in the larynx between the 2 major cartilages (cricoid and thyroid), peircing the cricothyroid membrane, in an emergency situation.

A TRACHEOSTOMY is a permanent/long term tube inserted lower down in the trachea, in hospital conditions, under anaesthetic (There are several important nerves down there and so this is a relatively more risky opperation than a tracheotomy which famously can be performed with a pen by someone with relatively little medical training, without anaesthetic in an emergency.). This image is a tracheostomy; it is correctly captioned in the article, but has an inaccurate file name and description. I can't really cite a source, I know this because I'm a medical student with a close relative with a permanent tracheostomy.

Note: I am a british medical student. In britain, the above is the case, but from a few confused web pages i have seen that either there is a massive confusion over the nomenclature or there is a difference between british and american nomenclature. It may be the case that in america, what i have described as a "tracheotomy" is called a "cricothyrotomy" and what I have described as a "tracheostomy" is called a "tracheotomy". What I do know is that this article refers to both procedures and calls them both "tracheotomies" (e.g. the reference to M*A*S*H and Scrubs, were what i call a tracheotomy, not what i call a tracheostomy; the "how to" is that of what i would call a tracheostomy), so something's wrong somewhere.

--KX36 22:05, 11 December 2006 (UTC)

I agree. I'm a respiratory therapist in America, and I see cricothyrotomies done on TV all the time, and called tracheotomies. In addition, when I correct them here on Wikipedia, they are invariably reverted by those with little to no medical knowledge. At my facility in Michigan, we generaly describe the procedure as a "tracheotomy" and the hole as a "tracheostomy" (of course, we generally just call both "trachs". I won't say this is the official American English distinction, but that's what we do. IronLung2533 21:55, 29 March 2007 (UTC)


 * Unfortunately this happens a lot on WP. Please add this info to correct the article, together with a reference.  Then we will make sure that it stays corrected. -Pgan002 05:39, 5 November 2007 (UTC)

I agree with some of the above. I am a respiratory therapist in Canada (so somewhere between UK and US English I suppose) and if you go to the roots of tracheotomy and tracheostomy (Greek, I think, not Latin), tracheotomy is the act of performing an incision into the trachea (a verb) and tracheostomy is the actual opening or hole that has been made into the trachea (a noun). A cricothyrotomy is in fact the act of creating an opening between the thyroid and cricoid cartilages but I wouldn't really think of it as a tracheotomy. Yes it's an emergent, short term thing but these cartilages are above the trachea and not a part of it. I suppose the hole created would be a cricothyrostomy, although I've never heard the word used.DougMike1 (talk) 17:14, 29 October 2008 (UTC)

Link request
I would like to request that the following informational web resource be included under External Links:

http://hopkinsmedicine.org/tracheostomy (Videos, FAQs for patients, caregivers and patients) - Johns Hopkins Medicine

This is an educational resource for patients, caregivers and physicians and includes videos, FAQs that are answered promptly by a nurse practitioner specifically trained in trachoestomy care and information for living with and caring for a tracheostomy.

Apulcinella (talk) 20:49, 12 March 2008 (UTC)

Waterboarding?
Not clear how important that mention is, albeit topical. Should we list every other case in which a tracheostomy might be performed? — Charlie (Colorado) (talk) 18:38, 7 May 2009 (UTC)

Tracheotomy/Tracheostomy in popular media
Seems inappropriate in a medical article. Is there really a need for such information here? Wjousts (talk) 20:50, 8 October 2009 (UTC)

Misuse of sources
This article has been edited by a user who is known to have misused sources to unduly promote certain views (see WP:Jagged 85 cleanup). Examination of the sources used by this editor often reveals that the sources have been selectively interpreted or blatantly misrepresented, going beyond any reasonable interpretation of the authors' intent.

Please help by viewing the entry for this article shown at the cleanup page, and check the edits to ensure that any claims are valid, and that any references do in fact verify what is claimed. Tobby72 (talk) 10:45, 5 September 2010 (UTC)

Cricothyrotomy, a similar procedure.
In an emergency setting a cricothyrotomy "crike" is often performed. The general public uses "trach" and "crike" as synonyms when there very different and often in the media in situations where a cricothyrotomy would be indicated a tracheotomy is performed. Also sometimes when a cricothyrotomy is done it's called a trach. Added a note note about the cricothyrotomy to avoid confusion. 67.253.15.163 (talk) 20:34, 19 June 2011 (UTC)

Respiratory Distress as a sign for Tracheotomy Care
I added a few sentences on the indication for tracheotomy tubes for respiratory distress in a patient. This seemed to be left out of the section. I felt it was important to note that tracheotomy can be used for multiple indications. Aendicot (talk) 01:54, 14 October 2011 (UTC)

Death after percutaneous tracheostromy
10.1186/cc13085 is a systematic review of causes of death. The rate is about 1:600. This could replace some current primary sources. JFW &#124; T@lk  13:37, 11 November 2013 (UTC)

Original Research Removed
Section which reads as follows removed due to lack of citations as well as poor language and syntax:

In popular culture

In the 2013 American comedy film The Heat, Sandra Bullock's character performs an unnecessary emergency tracheotomy on a choking man.

In Saw V detective Peter Strahm does this to himself by a ballpoint pen, preventing him from drowning in one of the antagonist's traps.

In Nancy Drew(2007 movie) ,Nancy Drew will perform on a boy who was having breathing difficulties due to allergic reaction to peanuts.

This should not be restored in its current state 81.152.63.82 (talk) 18:20, 8 June 2014 (UTC)
 * WP:SOFIXIT applies. Plot summaries do not need citations and they are NPOV and should be included. Nonetheless, I'll find a source for all of them and readd it. Tutelary (talk) 18:38, 8 June 2014 (UTC)
 * I've done such. An edit is not original research if it can be pointed to a source that states the same. It is not original research thereby that definition. Tutelary (talk) 18:50, 8 June 2014 (UTC)

"Evil" surgeons?
This bit needs reworking: "By the late 19th century, some surgeons had become evil in performing the tracheotomy."

121.223.185.214 (talk) 23:23, 15 September 2015 (UTC)InnocentBystander

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WikiMed Fall 2018 Work Plan
Hello! I am a 4th year medical student working on revising this article over the next couple of weeks as part of a course to improve Wikipedia’s medical content. My specific goals include:


 * 1) Indications- I plan to reorganize and expand this section (More information regarding emergency access. Further discussion of “late vs early” tracheostomy)
 * 2) Parts- More information regarding Passy-Muir one-way valves
 * 3) Complications- I plan to expand this section, specifically stating potential complications
 * 4) Alternatives- finding possible citations
 * 5) Overall- review of the page with some edits for clarity with possible additions to make the page more accessible to nonmedical laypeople. Possible inclusion of additional pictures.

Please let me know if you have any suggestions or recommendations! Kwanster8 (talk) 20:16, 2 December 2018 (UTC)

Hi Kwanster8,

Great additions to the page. Knowing the indications and understanding the ongoing debate of when to place a tracheostomy is important to patients and families. My overall impression is that the tracheotomy page is organized with an appropriate amount of content and tone. I only have a few comments:
 * 1) Under the complications section, the immediate/early complications are described. Adding trach displacement/dislodgement, either spontaneously or during trach change, as an early complication may provide the reader with a more complete idea of what to expect as a patient. A review article here may offer some insight DOI:10.4103/ijrc.ijrc_12_17
 * 2) Additionally, adding a long-term complication like tracheal stenosis may similarly enrich the page. A meta-analysis of tracheal stenosis s/p percutaneous vs surgical tracheotomy may help DOI:10.1097/CCM.0000000000001382
 * 3) With that said, these complications are more related to tracheostomy and not really to the actual tracheotomy. If you decide that these two complications do not belong on the page, then I think that would also be reasonable.
 * 4) I love the Passy-Muir parts - important to visually understand the nuts and bolts of the device that assists/replaces a patient's airway
 * 5) Some of the other sections could use another citation or two, but the areas that you focused on are great
 * 6) Doing a once over of the page to clarify some of the medical terms would be helpful; not a particularly big issue on this page, but I feel like every medical wiki page could always use a touch up in this regard

Happy to further discuss!

- Ucsfwikielective2018

Thanks for the review and suggestions! I've incorporated some more information regarding the potential complications you mentioned in addition to further clarifications of medical terms. I will plan to do another once over of the page again for readability. Kwanster8 (talk) 20:56, 19 December 2018 (UTC)

FEATHER'S are one of the main instruments used in this procedure? Vandalism? (And unuseful reference #11?)?
As of this date, in the section Surgical Procedure, sub-section Instruments, the text for main instruments used reads, "“Two small scalpels,...,ligatures, sponges, a flexible catheter, and feathers.", with a reference #11, which reference reads, "Rosen H (January 1897). "On enactment". Journal of the American Psychoanalytic Association. 40 (4): 1228–9. doi:10.1097/00000441-189701000-00008. PMC 1430766. PMID 1430766.". I expect the mention of feathers is vandalism? Feather's are not mentioned anywhere else that I could see in this article, though I did read the the popular media section of the companion article Cricothyrotomy that in a TV episode of Dr. Quinn, Medicine Woman the hollow quill of a feather was used. And I can only find a brief two page review of a aged book on general bandaging practices in the reference #11, which therefore doesn't seem to support any of the information it's referencing in this article, including specifically any of the instruments used in this procedure (maybe I'm reading the reference wrongly?). UnderEducatedGeezer (talk) 08:25, 1 November 2019 (UTC)

Far too much detail
This article contains far too much detail for an encyclopedia. Accordingly, I have trimmed it a bit. DiverDave (talk) 04:33, 25 October 2022 (UTC)