Tracheostomies.

Emergency physicians should be able to quickly evaluate and initiate therapy for tracheostomy tube obstruction, tracheal hemorrhage, interstitial air leading to pneumothorax, and infections throughout the lower respiratory tract. Familiarity with tracheal tubes and their function is a prerequisite to dealing with immediate distress in these patients. Emergency maneuvers including proper suctioning, cannula removal, cannula insertion, balloon hyperinflation, and endoscopy will ensure that tracheostomy patients avoid complications. The many other disorders of the tubes, trachea, esophagus, and soft tissues need to be kept in mind when evaluating tracheostomy patients when symptoms or signs are unusual or strange. Although associated with many complications, patent tracheostomies allow many patients to bypass difficult pathology and access life through an adequate airway.