How Tracheostomy Care Has Improved Over the Last 100 Years

Ensuring a steady flow of air to our lungs is vital for sustaining life. In situations where illnesses or injuries prevents normal breathing, one procedure that proves beneficial is a tracheostomy. This involves creating an opening in the windpipe and inserting a tube.

Tracheostomy has a long history, but significant advancements have occurred in the last century, enhancing this life-saving procedure.

Let’s explore the notable tracheostomy improvements over time. We’ll summarise tracheostomy history and care, making sure to include important historical aspects.

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Understanding Tracheostomy:

Before delving into the advancements, let’s revisit what a tracheostomy involves. The trachea is the air tube running from the back of the nose to the lungs.

During tracheostomy surgery, a cut is made between 2 to 4 rings of tracheal cartilage, creating a hole for inserting a curved tube known as a tracheostomy tube.

This tube allows direct delivery of air to the lungs, bypassing the nose and mouth.

It proves invaluable for individuals facing challenges in obtaining sufficient oxygen through regular means and may remain in place for weeks or months as required.

Tracheostomy Through History:

Tracheostomies have a rich historical background, with key events including:

• 1000 BC: Descriptions of procedures that resemble tracheostomies in ancient Hindu texts.
• 100 BC: Greek physician Asclepiades reportedly conducts tracheostomies using reed tubes.
• 1800s: Standardisation of the surgical method by surgeons. In the 1700s, surgeons like Antonio Bianchi started making surgery safer and more accurate by setting standard methods.
• 1909: Modern metal tracheostomy tubes designed by Chevalier Jackson. This brought in a new era of better materials and functionality.
• 1920s: Common use of the technique for treating polio.
• 1960s: Improvement in tracheostomy care in ICU settings.
• Today: Over 100,000 tracheostomies performed annually in the US [National Library of Medicine]. Around 15,000 new tracheostomies are performed in England and Wales annually [Source: The Health Foundation].

Tracheostomy in history has become better over the years, thanks to medical researchers working tirelessly to improve patient’s care.

Tracheostomy Evolution: Growth in the Last Century:

Early 1900s Trajectory:

In the early 1900s, tracheostomy was still relatively new, and various approaches were taken. Key improvements during this era included:

• Enhanced sterility of surgical tools and bandages, reducing infection risks.
• Introduction of anesthesia to alleviate surgical pain.
• Safer recovery in hospital settings.

However, tracheostomies were primarily reserved for life-threatening emergencies.

Rise of Polio Cases in the 1930s-50s:

During the mid-1900s polio epidemic, tracheostomy emerged as a critical treatment. As polio paralysed muscles necessary for breathing, tracheostomy facilitated direct air entry into the lungs, leading to several advances:

• Standardisation of procedure steps by surgeons.
• Design of specialised tracheostomy tubes.
• Establishment of hospital wards focusing on post-tracheostomy care.

Tracheostomy became a routine surgery to save lives during the polio crisis.

Intensive Care Advances in the 1960s-70s:

Significant improvements occurred as tracheostomy patients transitioned to Intensive Care Units (ICUs), incorporating:

• Closer monitoring using oxygen sensors.
• Suctioning to clear mucus from tubes. [ Follow the link Suction Training and full course content]
• Humidifying air before delivery to the trachea.
• Enhanced prevention of complications, such as infections.
• Gradual weaning of patients from ventilation. [ Enrol your team for our Ventilation Awareness Training]

These advancements transformed tracheostomy care.

Surgical and Tube Innovations:

In the surgical domain, new techniques emerged, including:

• Percutaneous dilation – inserting the tube through a small hole instead of a long neck incision.
• Laser procedures – utilising lasers to create the opening.
• Dedicated tracheostomy teams – enhancing surgical skills.

Tracheostomy tubes also modernised with features like:

• Inner cannulas for easier cleaning without complete tube removal.
• Inflatable cuffs for a better seal and the ability to speak.
• Various shapes and materials for increased comfort.

Continued Improvements in Recent Decades:

Recent decades have witnessed ongoing enhancements in tracheostomy care, including:

• Advanced wound dressings aiding healing and reducing infection.
• Smaller tubes suitable for pediatric patients.
• Valved tubes allowing speech and eating.
• Early mobilisation for safer patient movement.

The Future of Tracheostomy:

Expected future innovations include:

• Custom 3D-printed tubes tailored to each airway.
• Bioengineering of trachea tissue.
• Robot-assisted procedures.
• Improved staff education and patient resources.
• At-home care technology like video scopes.
• Further improvements in speech and swallowing function
• New medications to speed tracheal healing

Tracheostomy continues to evolve, providing relief to more patients struggling with breathing difficulties.

Tracheostomy History: From Emergency Procedure to Routine Surgery:

Over the last century, tracheostomy has undergone a transformative journey – evolving from a desperate last resort to a standardised, common procedure.

Thanks to the efforts of medical pioneers, improved hospital care, and technological developments. It is now a safer and reliable procedure. Better than what it was.

Today, tracheostomies empower hundreds of thousands of patients – from premature infants to the elderly – granting them the ability to breathe and pursue life’s goals.

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The Latest Tracheostomy Research and How It’s Improving Care

Doctors and scientists are always looking for new ways to improve tracheostomy procedures and care. Research on tracheostomies happens across the world every day.

It will be good to also discuss some exciting recent tracheostomy research. We’ll look at how new discoveries are impacting patients and caregivers.

Why Research Matters

Research on tracheostomies:

• Finds improved techniques for the surgery itself.
• Creates better tracheostomy tubes.
• Develops safer patient care routines.
• Allows earlier mobilisation and speech.
• Reduces complications.

In short, research aims to make tracheostomies more successful for patients. Let’s look at some exciting recent studies.

1. Improving Tracheal Airway Size Analysis

Problem: Choosing the right-sized tracheostomy tube is crucial for comfort and healing. But measuring the trachea to select the tube size is challenging.

Researchers over the years have developed a new 3D scanning method to more accurately assess patient tracheal anatomy before surgery. This allows better tube size selection. This brings about personalising tracheostomy tube solutions to fit and improve patients care.

Impact: This technique reduces pain and complications from ill-fitting tubes. It leads to faster recovery.

2. Testing New Tracheostomy Tube Materials

Problem: Typical tracheostomy tubes are made of rigid plastic. The constant rubbing in the neck can cause injury and scar tissue over time.

Scientists tested tubes made of soft, flexible silicone in laboratory simulations. These conformed better to the trachea with less abrasion.

Impact: Silicone or other soft tubes may reduce tracheal irritation for some patients. This helps avoid future narrowing or blockages in the airway.

3. Evaluating Post-Breathing Swallow Function

Problem: Many patients can’t swallow safely after a tracheostomy until breathing function returns sufficiently. This delays eating.

Specialists compared methods to determine when swallowing could be attempted safely after surgery. Evaluating airflow and oxygen levels post-breathing tests proved most accurate.

Impact: Using these post-breathing tests allows doctors to introduce swallowing and eating sooner for patients. This improves nutrition and recovery speed.

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Top Clinical Training: PEG Feeding Training, Nasogastric Feeding Training, Cough Assist Training

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4. Studying Home Tracheostomy Care

Problem: Most tracheostomy research focuses on hospital care. But many patients live at home for months with their tracheostomy.

Researchers examined the safety of at-home tracheostomy management by caregivers and patients themselves. With proper tracheostomy training, home care was not associated with more complications.

Impact: This supports sending patients home earlier and provides confidence for outpatient caregivers. Home recovery is possible for many patients.

5. Developing Innovative Tracheostomy Tubes

Problem: Typical tubes are simple curved plastic or silicone. But some patients would benefit from tubes with special features.

Engineers created new tube designs like:

• 3D-printed tubes customised to each patient’s tracheal anatomy
• Tubes containing sensors to track oxygenation
• Tubes coated with antibiotics to prevent infection
• Biodegradable tubes that dissolve after healing

Impact: Specially engineered tubes like these may improve outcomes and quality of life for tracheostomy patients in the future.

6. Analysing Ideal Timing for Speaking Valve Use

Problem: Speaking valves help patients talk with their tracheostomy but have some risks if used too early before airway swelling subsides.

A research review concluded that modern stabilisation procedures allow safe placement of speaking valves within the first week after tracheostomy.

Impact: Earlier speaking valve use enables communication, reduces frustration, and improves mental health.

7. Studying Impacts on Swallowing

Problem: Many patients experience swallowing difficulties (dysphagia) with liquid and food getting into the airway after tracheostomy.

Experts analysed the effects of tracheostomy tubes on swallowing muscles and airflow. Results are helping develop therapies to strengthen muscles and redirect airflow to make swallowing safer.

Impact: This research will allow specialised swallow treatment so patients can return to eating more normally.

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Other Clinical Trainings: Catheterisation Training, Catheter Care Training, Anaphylaxis Training

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8. Reducing Sedation Needs

Problem: Patients are often kept heavily sedated during and after tracheostomy procedures to remain still and avoid displaced tubes.

Recent studies have shown that precise surgical techniques allow reducing sedation doses. Patients can wake sooner and become mobile faster.

Impact: Reduced sedation allows for earlier standing, walking, and participation in care from patients. This facilitates recovery.

Exciting new developments lie ahead! But even small improvements today can significantly help patients and their caregivers.

All tracheostomy research aims to improve care and quality of life a little bit more. Through dedicated researchers and generous patients participating in clinical trials, progress happens every day.

This concludes our discussion on the history of tracheostomy over the last 100 years and highlights recent developments within the field. To know more about tracheostomy procedures within the UK.

You can join our face-to-face tracheostomy training in the UK. Call our number for enquiries and bookings: 01782 563333 or send an email: enquiries@caringforcare.co.uk.