Fenestrated vs Non-Fenestrated Tracheostomy Tube (Medical Overview)

a tracheostomy is a surgical procedure that involves making

an incision in the neck in order to create an opening into the trachea

a tracheostomy tube is then inserted into the opening in order to provide an artificial airway

to help a patient breathe in general there are two different types of tracheostomy tubes

fenestrated and non-fenestrated there are some similarities and key differences between the two

and that is exactly what we are going to discuss in this video so if you're ready let's get into it

as previously mentioned a tracheostomy tube is a cylindrical tube that is inserted through an

incision in the neck and into the trachea the tube has a hollow center which allows

air to pass through so that breathing can occur a tracheostomy tube is indicated when a patient is

unable to breathe on their own or when they are in need of long-term mechanical ventilation

the tube helps to keep the airway open so that gas exchange can occur within the lungs

there are a few key differences between fenestrated and non-fenestrated tracheostomy tubes

the primary difference is whether or not the tube has a fenestration or a small hole in

the side a fenestrated tracheostomy tube has an opening in the side of the tube above the cuff

which allows air to enter so that the patient is able to speak with the tube in place a

fenestration is simply a term that refers to the hole or opening in the shaft of the tube without

set opening no airflow can pass through the vocal cords which means that the patient will be unable

to speak with the tube in place a non-fenestrated tracheostomy tube is a type that does not have an

opening in the shaft of the tube this means that air cannot pass through the vocal cords with the

tube in place and as a result the patient will be unable to speak non-fenestrated tracheostomy tubes

are generally the first type of tracheostomy tube that is inserted however if a patient is in need

of long-term tracheostomy placement a fenestrated tracheostomy tube is usually inserted in order to

allow the patient to communicate now let's talk about the tracheostomy tube parts all types of

tubes are composed of several parts that make up the artificial airway including the inner cannula

outer cannula pilot balloon cuff flange obturator and the fenestration understanding the different

parts of a tracheostomy tube is important in order to understand how the tube works

and its overall function also there are a few potential complications that can occur with

the tracheostomy which include infection incorrect positioning damage to the mucosa

airflow obstruction accidental decannulation tracheomalacia tracheal esophageal fistula

pneumomediastinum tracheal stenosis and bleeding while there are potential complications that

can occur it's important to keep in mind that most are rare and can be avoided with proper

tracheostomy care and you may be wondering what exactly that is tracheostomy care is the process

of cleaning and caring for the tracheostomy sites to prevent infection and other complications

this includes gentle cleansing of the skin around the stoma as well as the changing

of the tracheostomy tube and inner cannula as needed tracheostomy care is typically a job duty

of respiratory therapists although nurses are often involved in the process as well

so now let's talk about suctioning fenestrated tracheostomy tubes tracheostomy tube suctioning is

a therapeutic process that helps remove secretions from the trachea with the use of a suction

catheter this helps prevent the accumulation of secretions in the airways which can lead

to an obstruction and difficulty breathing when suctioning a fenestrated tracheostomy tube it's

important to be aware of the opening in the side of the dupe that is because the suction catheter

can potentially go through the opening and cause damage to the tissues of the tracheal wall another

common question that often comes up is this can a patient talk with the tracheostomy tube in place

as previously mentioned whether or not a patient can talk with the tracheostomy tube in place

depends on the type of tube that is being used a fenestrated tracheostomy tube has a small hole

in the side of the tube that is placed over the patient's vocal cords which allows them to speak

with an uncuffed tracheostomy tube patients may be able to speak if they are able to generate

enough air flow through their upper airway however most uncuffed tubes are too small in diameter to

allow for adequate airflow and therefore patients are unable to talk cuffed tracheostomy tubes have

an inflated cuff around the distal end of the tube that creates a seal between the tube and

the patient's trachea this prevents air leaks and aspiration but it also blocks off the patient's

vocal cords making it impossible for them to speak with this type of tube in place if you

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i think you will enjoy and just a quick reminder we are not doctors this video is for informational

purposes only thank you so much for watching have a blessed day and as always really easy my friend