Ear, nose & throat · UKMLA & AKT
Tracheostomy management
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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