KEY NOTES

The placing of a tracheotomy tube is a first aid procedure that may save the life of an animal in the event of acute upper airway obstruction.

If there is time, the ventral mid-line of the neck should be clipped and the skin surgically prepared. Local anaesthetic may be administered. In a peracute emergency, time is of the essence and therefore you must be prepared to perform the procedure immediately with no preparation.

The following equipment should always be ready for an emergency: 

• Curved scissors/clippers.
• Surgical scrub such as Hibiscrub/Pevidine.
• 70% Alcohol solution.
• Swabs/cotton wool.
• Syringes and hypodermic needles.
• Local anaesthetic.
• Size 15 scalpel blades.
• Tracheotomy tubes in various sizes.
• Suture material/white open weave bandage.
• Suture needles.

1. Prepare the skin BUT ONLY IF THERE IS TIME.
2. Place a wide-bore needle between two tracheal rings.
3. Supply 100% oxygen.
4. The veterinary surgeon will then be able to proceed as follows:
5. Using a size 15 scalpel blade, make a skin incision ventral to the mid-line, over the trachea and immediately behind the larynx.
6. Gently separate the underlying muscles to expose the cartilaginous rings on the ventral surface of the trachea.
7. Incise the trachea between the 2nd or 3rd pair of tracheal cartilages.
8. Insert a suitably sized tracheotomy tube. Proprietary sizes are available in 6mm, 7mm and 8mm, and usually possess a soft, low-pressure cuff, adjustable fixation collar, an adapter, linen tapes for fixation and a semi-rigid suction catheter which may be used as an introducer. If a suitably sized tracheotomy tube is not available, an endotracheal tube or other soft tubing may be utilised.
9. Fix the tracheotomy tube in place with ties or sutures.

Notes:

• It is essential that the tracheotomy tube be cleaned with saline every 2-3 hours in order to prevent a build up of mucus, which will cause an obstruction.
• Some tracheotomy tubes have an inner and outer sleeve to enable easier cleaning, but if this type of tube is not available, mucus may be aspirated by means of an intravenous catheter or short length of 3FG catheter tubing attached to a 10ml or 20ml syringe.
• In a dire emergency a wide gauge hypodermic needle may be used in place of a tracheostomy tube.
• Remember that a tracheotomy is different to a tracheostomy! A tracheostomy is a permanent opening into the trachea and is rarely indicated in cats and dogs.