What are the components of a typical tracheostomy tube?
- Typically made up of three parts:
Outer Tube
- A curved plastic tube with a proximal flange that is sutured or tied in position on the neck
- Has a proximal 15 mm connection for a breathing system (some designs require inner tube to be places to connect to a standard 15mm circuit)
Inner Tube
- A simple plastic sleeve that slides inside the outer tube
- May easily be removed to allow cleaning or if plugged with secretions
- Paediatric tubes are often of a single-cannula design (without an inner tube)
Obturator
- A plastic insert with a bullet-shaped tip that protrudes from the tracheostomy tube
- Used to facilitate tube insertion and must be removed in order to ventilate
What are the features of a standard tracheostomy outer tube?
Tube Shaft
- Curved or angled (110° to 135°) tube to conform closely to the anatomy of the trachea
- Often have a tapered tip to aid insertion
- Square cut tip (not bevelled) to reduce the risk of obstructing the tube against the wall of the trachea
15mm Connector
- 15mm connector is attached to allow the tracheostomy tube to be attached to a breathing circuit for ventilator support
- May be found on the inner tube on certain types of tracheostomy
Cuff, Pilot Balloon & Port
- Creates a seal to facilitate positive pressure ventilation and prevent from aspiration
- High-volume low-pressure cuffs most commonly used
Neck Flange
- Allows tube the tube to be fixed in place by ribbons tied around the patients neck or by sutures
Subglottic Port
- Linked via an integrated channel to a small hole in the shaft of the tube above the cuff
- Allows secretions that pool above the cuff to be removed by suction