Ear, nose & throat · UKMLA & AKT
Tracheostomy management
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise tracheostomy management — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Upper airway obstruction - tumour, trauma, foreign body, severe infection (e.g. Ludwig's angina), post-operative oedema; tracheostomy bypasses the obstruction
- Prolonged mechanical ventilation - most common ICU indication (up to 24% of ventilated patients); recommended when ventilation expected to exceed 21 days; reduces dead space, work of breathing, and sedation requirements
- Secretion management - bulbar palsy, high spinal cord injury, neuromuscular disease; allows direct tracheal suctioning
- Aspiration risk reduction - unsafe swallow, absent gag reflex; note a cuffed tube does not fully prevent aspiration
- Post-laryngectomy - permanent end-tracheostomy; no inner tube required
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