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Showing posts with label trach. Show all posts
Showing posts with label trach. Show all posts

May 25, 2020

ENT Reviews Numerous Medical Scenes from Film and TV [VIDEO]

Over the past few weeks, I have created several videos on YouTube critically reviewing numerous ENT-related medical scenes from TV and film including Grey's Anatomy, House, Chicago Med, Private Practice, Family Guy, The Heat, Cardiac Arrest, etc. ENT topics covered include nasal spray addiction (above) as well as videos below covering emergency trach/crics , severe nosebleed management , otosclerosis , and a severe headache due to Sluder's neuralgia. Depending on how well thes…
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February 04, 2016

How Fast Should an Emergency Tracheostomy Take?

Image courtesy of digitalart at FreeDigitalPhotos.net When faced with an emergency airway situation, a surgical airway may be required in order to save a person's life. Such surgical airways include emergency tracheostomy or cricothyroidotomy. The main question here is how quickly should such a procedure take in order for it to be considered a success? Clearly, it should take less than 4 minutes given that is how long a brain can survive without oxygen before permanent damage sets in…
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December 23, 2014

Deputy Performs Life-Saving Tracheostomy on 12 year old in Car Accident

Image from WYFF4 On Nov 8, 2014, there was a terrible car accident that claimed the lives of 3 young adults and another barely hanging on. EMS workers who arrived on the scene found 12-year-old Cheyenne Queen trapped in the car and barely breathing. A deputy coroner on the scene was called to assess Cheyenne and determined that a trach was the only way to give her a fighting chance at survival. An emergency on-the-field tracheostomy was performed and was felt to have saved her life. On D…
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December 18, 2014

How a Tracheostomy Hole Heals Closed (Time Lapse)

When a patient undergoes a tracheostomy , it is not a permanent thing. Once a patient is healthy enough, the tracheostomy tube can be removed and the existing hole in the throat will spontaneously start to heal closed. In a process called healing by secondary intention, the body creates granulation tissue along with scarring that slowly but surely closes the trach opening shut. In the rare situation it does not completely close, a surgical procedure can be performed. Here are some pictures…
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February 05, 2014

Man Sues ENT for Wrongful Tracheostomy

Image from ParaMedicine101 In December 2012, a West Virginia man suffered angioedema causing tongue swelling due to a not uncommon reaction from lisinopril . Presumably due to airway concern from the tongue swelling, an urgent tracheostomy (cutting a hole in the throat) was performed. The patient later filed suit against the ENT who performed the tracheostomy stating that it was unnecessary as the tongue swelling was getting better. [ link ] Although a tracheostomy is not always perf…
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December 09, 2013

Tracheostomy Fire During Surgery Burning Patient

Image from Wikipedia In early 2012, a surgeon was performing a trach (breathing hole in the neck) when the oxygen used during the procedure caught fire severely burning the patient. Apparently, the surgeon used an electrocautery device which most likely emitted a spark igniting the oxygen being given to the patient leading to the fire. [ link ] What happened? Tracheostomy procedures are performed typically in very sick patients who have been intubated for a prolonged period of time. …
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October 30, 2013

Submental Intubation [video]

Holy moly... Never realized submental intubation was actually a procedure that really is performed. Check out this video (or watch below) showing a submental intubation being performed. First, an incision is created right below the jawline slightly off from midline. Dissection is bluntly carried right to the floor of the mouth under the tongue. The endotracheal tube is than grasped and pulled through this opening resulting in a submental intubation. Seems quick and elegant with minimal b…
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September 25, 2013

Life-Saving Emergency Trach Performed in Restaurant

On Sept 23, 2013, a physician performed a life-saving emergency tracheotomy in a restaurant on a patron who was choking on a piece of meat. [ link ] While eating dinner at The Mark Restaurant in California,  Dr. Royce Johnson , an infectious disease doctor affiliated with UCLA, performed this procedure on Pauline Larwood, a female supervisor and a community college trustee. Dr. Johnson saved this woman's life using a pocket knife and the hollow cylinder of a pen after a Heimlich maneu…
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April 17, 2013

Scam Tracheostomy in Hospital Leading to Arrests

Image from Wikipedia A Chicago hospital owner and a few doctors were arrested in a horrific scandal involving deliberately  over-sedating patients thereby ensuring a patient will not be able to come off the breathing machine leading to the excuse needed to perform a tracheostomy [ link ]. All done in the name for greater profits. This scandal is particularly notable given it has come right at the heels of a New York Times story  which reported that hospitals often profit from surgical err…
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December 04, 2012

Celebrity Actors Who Have Received a Trach (Catherine Zeta Jones Included)

Image Taken From www.TopScarCream.com Tracheostomy (also known as trach) is when a hole is made in the midline neck directly into a person's windpipe ( watch video ). Although many people may shy away from this deforming procedure, it can be life-saving. On that note, here is a short list of famous celebrity actors who have undergone an emergency trach for one reason or another: Catherine Zeta-Jones Apparently, when she was a child, she had an emergency trach done. She still has a…
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November 27, 2012

Is Patient Abandonment in the Operating Room Ever Justified?

I ask this question mainly because there WAS an ENT who WAS sued for NOT abandoning his patient in the operating room [ link ]. No way to verify, but additional details can be found in this facebook post . Imagine this hypothetical scenario (as details from original case are not available)... You are an ENT surgeon in a rural community hospital performing a fairly difficult but elective sinus surgery on a 12 years old child with cystic fibrosis with extensive pan-sinus nasal polypoid d…
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July 07, 2012

Creative Ways to Wear a Scarf for Patients with a Trach or Ugly Neck Scar

[Watch the video below!!!] Given I operate on the neck not uncommonly... a common fear for a patient is how the incision will look afterwards. For a simple neck mass excision, the incision almost always heals just fine to the point nobody will notice the scar. However, this concern is multiplied a hundred-fold when a patient undergoes a tracheostomy (hole in neck) for severe obstructive sleep apnea or for some other airway reason. It could even be a laryngectomy where the entire voi…
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December 23, 2011

Singer George Michael With Tracheostomy

Reuters reported today that singer George Michael suffered from severe pneumonia and underwent a tracheostomy during his hospitalization. A tracheostomy is when a hole is made in the throat for a patient to breath through. Here is a video of what his trach surgery may have looked like. Michael apparently was in the middle of a tour when he became ill requiring him to cancel upcoming shows. A tracheostomy is often performed whenever a patient has been intubated (tube down the throa…
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September 30, 2011

Woman Survives Live Grenade Lodged in Face

A 32 year old Mexican woman, Karla Flores, survived extraction of a live grenade from between her jawbones. Apparently, she was minding her own business when she was knocked out after something hit her face. Read report here . In the hospital, it was realized that rather than a stone as initially thought, it was a live grenade! Due to fear of it going off, 3 volunteer doctors and one nurse surgically removed the live grenade in an open field under direction of two explosive experts fr…
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September 10, 2011

Keychain Emergency Airway Device (Video)

Health professionals who know how to perform cricothyroidotomy to obtain an emergency airway in someone who is obstructing can appreciate a nifty keychain device called LifeStat . LifeStat can be carried around and immediately utilized to perform emergency cricothyroidotomy in any setting. Watch a video here to see how it works. It can be purchase from Shippert Medical for $145 here . Reference: Utilization of the LifeStat emergency airway device . Ann Otol Rhinol Laryngol. 2008 Ja…
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September 05, 2011

Best Ballpoint Pen for Emergency Cricothyroidotomy?

I recently blogged about a man who choked to death on an airplane and the impossibility of saving this man's life with a surgical airway like a cricothyroidotomy without a sharp object around inside the plane (ie, knife or scalpel). I also stated that "Some surgeons would argue a strong, stiff ball-point pen could have been used to perform the cricothyroidotomy, but as someone who has performed a dozen emergency cricothyroidotomies and tracheotomies in the past, even under the b…
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April 12, 2011

Doctors Don't Always Take Their Advice (ENT Perspective)

Reuters published an interesting story about research that showed doctors don't always recommend treatments to patients that they themselves would pursue if they were sick. In essence, if the doctor was the sick person, they would tend to pursue treatments that carry a higher risk of death but fewer severe side effects whereas patients pursue the exact opposite. Though the clinical scenarios illustrated in the article/research is not reflective of an ENT practice (colon cancer and bird…
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January 16, 2011

U.S. Rep. Gabrielle Gifford Gets a Tracheostomy After 7 Days of Intubation

U.S. Rep. Gabrielle Gifford who is recovering from a gunshot wound to the head 7 days earlier had her breathing tube removed and a tracheostomy tube placed on January 15, 2011. Many people will wonder why a tracheostomy tube was placed when she's been intubated for only 7 days and even though she has been able to breath on her own since Tuesday. Along with the trach tube, a stomach feeding tube was also placed. A tracheostomy tube is a small tube placed through an opening in the nec…
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December 02, 2010

April 21, 2010

How a Tracheostomy is Performed Step-by-Step with Pictures

Below is a step-by-step description with pictures of how a tracheostomy is performed. To read more about this procedure as what to expect with swallowing, eating, talking, etc, click here . Step 1:  Neck is sterilized with beta dine to clean the skin and draped to prevent any contamination from the environment. Step 2 : After the incision, underlying fat is removed. Step 3:  Dissection is carried down to the windpipe which is completely exposed in this picture. One can see the faint out…
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