The procedure of inserting a temporary
tracheostomy is common in the critical care
environment. Patients with tracheostomy tubes
are also frequently managed in ear, nose and
throat (ENT) departments. An increasing number
of patients with a tracheostomy are nursed in
other clinical environments and in the community
(Serra 2000, Docherty and Bench 2002, Lewis
and Oliver 2005). It is paramount that safe and
effective care is carried out by nursing staff in all
of these settings (Phillips 2005); however, there
are concerns that the standard of tracheostomy
care delivered is inadequate (Mace et al 2006).
The trachea extends from the larynx – a short
passage way positioned in the midline of the
neck– to the carina where it divides into the
right and left bronchi. The trachea is the first part
of the upper airway that is not shared with the
gastrointestinal tract. It consists of 16-20 rings
of cartilage resembling a C-shape. These rings of
cartilage prevent collapse of the trachea during
inspiration. In the average adult, the trachea
is 10-12cm long and 2.5cm in diameter (Tortora
and Derrickson 2011).
A tracheostomy is a surgically created opening
in the wall of the trachea, which can either be