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Thursday, June 5, 2014

Why are tracheostomies better than endotracheal intubation?

The general recommendation for the management of patients who require endotracheal intubation and mechanical ventilation is to extubate as soon as possible.  However, in the event a ventilator is required long term, the experts recommend the patient be trached after seven days.  

Why is this?  What are some advantages of tracheostomy over intubation? 

What follows are the essential advantages of tracheostomy over intubation:
  • More comfortable than an ETT
  • Makes it easier to wean a patient off a ventilator
  • Reduces need for sedation because it's not as uncomfortable as an ETT
  • Reduces risk of trauma to airway as might be causes by an ETT
  • Reduces airway resistance to make breathing easier for patients
  • Allows patient to breathe when upper airway is swollen or collapses (such as with paralysis caused by neuromuscular disorders or epiglotitis)
  • Makes it easier to suction the patient with thick, or copious secretions
  • A patient can talk with special trachs
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