ABSTRACT
This chapter aims to serve as an introduction to the types of tracheostomy tubes and their effect on the respiratory and swallowing mechanisms, and to provide an overview of assessment and management for clients with a tracheostomy and those requiring mechanical ventilation. The normal laryngeal protective responses can be affected by the presence of long-term endotracheal intubation or a tracheostomy tube. A percutaneous tracheostomy is normally a temporary and occasionally a permanent opening into the anterior wall of the trachea, below the vocal folds to prevent damaging the larynx. A cricothyroidotomy tube is usually inserted in an emergency when the client's anatomy will not permit the creation of a tracheostomy stoma and an airway is required. The normal warming, filtering and humidification of the inhaled air are disrupted owing to the presence of a tracheostomy tube and, as a result, the lower respiratory tract is more vulnerable to irritants.
