protection of the tracheo-bronchial tree
Last reviewed 01/2018
Protection of the tracheo-bronchial tree is required when there is pharyngeal or laryngeal incompetence which may cause aspiration of food, saliva, blood or gastric contents.
Endotracheal intubation is appropriate for conditions that are only of a short duration e.g. general anaesthesia.
Tracheostomy is indicated in chronic conditions as it allows easy access to the trachea and bronchi for regular suction, and permits the use of a cuffed tube which further protects against aspiration.
Tracheostomy should be considered in conditions such as:
- Guillain-Barre syndrome
- multiple sclerosis
- myasthenia gravis
- tetanus
- brain stem stroke
- bulbar poliomyelitis
- coma due to:
- head injury
- poisoning
- stroke
- cerebral tumour
- intracranial surgery
- multiple facial fractures