Wednesday, August 25, 2010

alternative airway.. another hole...

I've always wanted to do percutaneous tracheostomy but never had the chance to do it on your own. I've learnt about it either during conference or my postgraduate, but it has always been on a model or helping another to do it. In UM, we did not have any consultant to back us up therefore the young specialists were not so gung-ho about it. Besides that, if we were to plan for a perc.. then the patient had to fork out their own money for the set.. costing RM1000. And the prognosis and mortality can be high, and subjecting patients to fork out money for it can be a bit daunting.
Of course, with my current learning curve there will always be somebody senior supervising but I am really thankful for the chance to do it in Sungai Buloh. I guess Sungai Buloh ICU may have the highest rate of percutaneous tracheostomy performed, but i may have to check my statistics.
"Tracheotomy is a surgical procedure that is usually done in the operating room under general anesthesia. It ca also be done percutaneously by a simple Seldinger's technique with repeated dilatation. A tracheotomy is an incision into the trachea (windpipe) that forms a temporary or permanent opening which is called a tracheostomy. Sometimes the terms "tracheotomy" and "tracheostomy" are used interchangeably. The opening, or hole, is called a stoma. The incision is usually vertical in children and runs from the second to the fourth tracheal ring.
A tube is inserted through the opening to allow passage of air and removal of secretions. Instead of breathing through the nose and mouth, the patient will now breathe through the tracheostomy tube.
This is one skill I am trying to perfect it so that I am an expert.. and i guess, SUngai Buloh ICU can definitely provide me with that kind of intense training!! ENT surgeons!! I can do this too!!


dochisyam said...

Senang je bro.
Mke sure your pt selection is good...otherwise you will have to wake the ENT from their sleep


Mafeitz Mamat said...

hahaha.. the only ENT doc i know who reads my blog! thanx for the encouragement.. and i am expecting the complications to come with more trachys that i do.. nanti SOS Serdang.. haha