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Tracheotomy and tracheostomy are surgical procedures that create an opening in the trachea (windpipe) to help patients breathe when they have difficulty doing so through the nose or mouth. Though they are similar in purpose, there are some key differences between them.

Tracheotomy is a temporary procedure that involves creating a small incision in the trachea to insert a breathing tube. The tube is typically removed once the patient no longer requires it, and the incision heals on its own. Tracheostomy, on the other hand, is a more permanent solution that involves creating a hole in the trachea and inserting a tracheostomy tube, which remains in place for an extended period.

Indications for these procedures include:

Airway obstruction due to trauma, tumors, or infection
Severe respiratory distress or failure
Prolonged mechanical ventilation
Inability to protect the airway due to neurological disorders or impaired consciousness
Steps for performing a tracheotomy and tracheostomy:

Preparation: The patient is positioned, and the neck area is cleaned and draped. Local anesthesia is often administered, although general anesthesia may be used in some cases.
Incision: A small incision is made in the neck, and the muscles and tissues are carefully separated to expose the trachea.
Tracheal opening: A small opening is made in the trachea, typically between the second and third tracheal rings.
Tube insertion: A tracheotomy tube is inserted through the incision and into the trachea for a tracheotomy, while a tracheostomy tube is inserted for a tracheostomy. Both tubes are secured in place.
Confirmation: Proper placement of the tube is confirmed by listening for breath sounds and checking for adequate ventilation.
Pre-operative care typically involves a thorough assessment of the patient's medical history, as well as any necessary imaging studies or lab tests to ensure the procedure is appropriate and safe. Informed consent should be obtained from the patient or their legal representative.

Post-operative care includes monitoring the patient's vital signs, ensuring the tube remains secure and patent, and managing any pain or discomfort. For tracheostomy patients, regular cleaning and maintenance of the stoma (the opening in the trachea) and the tracheostomy tube are essential to prevent infection and other complications. Long-term care may involve speech therapy, respiratory therapy, and support from a multidisciplinary team to address any ongoing needs.

It's crucial to remember that these procedures should only be performed by trained medical professionals in a clinical setting.



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If you notice a patient beginning to fall, follow these steps to help lower them safely to floor. Always stay with the patient and call for additional help.

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Glioblastoma is a type of astrocytoma, a cancer that forms from star-shaped cells in the brain called astrocytes. In adults, this cancer usually starts in the cerebrum, the largest part of your brain

Our surgeons take a compassionate, family-centered approach to both inpatient and outpatient care. We’re committed to making sure both you and your child understand our process. Told through a kid's eyes, this video tour reveals our caring approach.

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The video will describe the position of ET tube on a chest x-rays. Please see my website for disclaimer.

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A natural, unmedicated approach to labor and birth will suit you best if you want to remain in control of your body as much as possible, be an active participant throughout labor, and have minimal routine interventions such as continuous electronic monitoring. If you choose to go this route, you accept the potential for pain and discomfort as part of giving birth. But with the right preparation and support, women often feel empowered and deeply satisfied by natural childbirth.

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Acute sinusitis can be triggered by a cold or allergies and may resolve on its own. Chronic sinusitis lasts up to eight weeks and may be caused by an infection or growths. Symptoms include headache, facial pain, runny nose, and nasal congestion. Acute sinusitis usually doesn't require any treatment beyond symptomatic relief with pain medications, nasal decongestants, and nasal saline rinses. Chronic sinusitis may require antibiotics.

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Common causes of the knee pain
Knee pain is very common and in this video we will present the most common problems that can cause pain in the knee. (Patella) itself, which is in front of the knee, or from the tendons that are attached to the kneecap (patellar tendon and quadricep tendon). One of the most common problems is patellar chondromalacia which is chronic pain due to the softening of the cartilage beneath the kneecap. The cartilage of the kneecap will have some erosions, defects, or holes from mild to complete inside the joint (exactly in the back of the kneecap).
• Pain in the front of the knee
• Occurs more in young people
• Becomes worse from climbing up stairs and going downstairs
Treatment is usually nonsteroidal anti-inflammatory medication, physical therapy, and surgery is very rare. Also in front of the kneecap, the patient may get pain due to prepatellar bursitis.
When there is prepatellar bursitis, the patient will see that the swelling, the inflammation, and the pain is located over the front of the kneecap. The bursa becomes inflamed and fills with fluid at the top of the knee, causing pain, swelling, tenderness and a lump in that area on top of the kneecap. If the pain is in front of the knee but below or above the patella, this may indicate that the patient has tendonitis. Patellar tendonitis is an overuse condition that often occurs in athletes who perform repetitive jumping activities. Patellar tendonitis is a knee pain that is associated with focal patellar tendon tenderness and it is usually activity related. It is located below the kneecap and is called "jumper's knee". Patellar tendonitis affects approximately 20% of jumping athletes. There will be tenderness to palpation at the distal pole of the patella in extension and not in flexion. Quadriceps inflexibility, atrophy and hamstring tightness are predisposing factors for this condition. Treatment is rest, anti-inflammatory medication, stretching and strengthening of the hamstrings and quadriceps. Use an eccentric exercise program. The early stages of patellar tendonitis will respond well to nonoperative treatment. Another important cause of knee pain is a meniscal tear. The meniscus is the cushion that protects the cartilage in the knee. Injury will cause pain on the medial or the lateral side of the knee exactly at the level of the joint. The patient will complain of a history of locking, instability and swelling of the knee. McMurray test will be positive. A painful pop or click is obtained as the knee is brought from flexion to extension with either internal or external rotation of the knee. Arthritis of the knee Knee arthritis is very common. The cartilage cells die with age and its repair response decreases in the joint collapses with increased breakdown of the framework of the cartilage. The patient will have progressive blurring away of the cartilage of the joint with decreased joint space as seen on x-rays. Another source of pain is the Baker's cyst. The cyst is in the back of the knee between the semimembranosus yes and the medial gastrocnemius muscles. Another important source of knee pain is a ligament injury. Here is a normal knee without a ligament injury. Here you can see from the front, you can see the lateral and medial collateral ligament. You can see the ACL and PCL from the side view. These ligaments are usually injured as a result of a sports activity. Here is an example of a sports knee injury. Here is an example of the medial collateral ligament injury. This is the most commonly injury knee ligament injury to this ligament is on the inner part of the knee. Here is an example of an injury of the anterior cruciate ligament. It involves a valgus stress to the knee. Lachman test is usually positive, and MRI is diagnostic. Another important cause of knee pain is iliotibial band syndrome of the knee. Inflammation of the thickening of the iliotibial band results from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. And as the knee moves, the IT band was repeatedly shifted forwards and backwards across the lateral femoral condyle. The patient will complain of swelling, tenderness, and crepitus over the lateral femoral condyle. The condition occurs in the ITB S occurs in runners, cyclist and athletes that require repeated knee flexion and extension. The pain may be reproduced by doing a single-leg squat. The Ober's test is used to at assess tightness of the iliotibial band. MRI may show edema in the area of the ITB. Treatment is usually nonoperative with rest and ice, physical therapy, with stretching, proprioception, and improvement in neuromuscular coordination. Training modification and injections may be helpful. Surgery is a last resort. Surgical excision of the scarred inflamed part of the iliotibial band.

Bandaging a freshly above the knee amputated limb

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Have you heard any medical lingo you've thought is strange? Funny healthcare speaker Dr. Brad Nieder discusses funny medical terminology he's learned in his medical career. He brings his medical comedy to a healthcare conference, describing how he didn't know what "stat" meant.

He goes on about how he thought up many funny terms he could say in return to the doctor who introduced him to the word. His healthcare comedy makes the crowd burst with laughter.

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