Tracheostomy and Percutaneous Enteral Feeding Tubes

First Things First (assess & treat for the following)

• Tracheostomy
  • Once used primarily for emergency mgt of upper airway obstruction; has evolved into an elective, bedside procedure in pts requiring prolonged ventilatory support.
  • Open tracheostomy (OT): open procedure performed at bedside or in OR. Allows direct visualization of trachea during cannulation.
  • Percutaneous dilational tracheostomy (PDT): alternative to OT; can be performed at bedside or in OR. Seldinger technique used for tracheal dilatation & tracheostomy tube placement.
• Percutaneous enteral feeding tubes
  • Enteral nutrition is an important component in the mgt of critically ill pts.
  • Percutaneous enteral access developed as an alternative to laparotomy for feeding tube placement (eg, open gastrostomy & open jejunostomy).
  • Percutaneous enteral feeding tubes encompass a variety of techniques
    • Percutaneous endoscopic gastrostomy (PEG)
    • Percutaneous endoscopic gastrojejunostomy (PEGJ)
    • Percutaneous radiologic gastrostomy (PRG)