Understanding the Tracheostomy Tube
A tracheostomy involves a surgically created opening, also known as a stoma, in the windpipe, or trachea, to establish an airway. This procedure allows air to bypass the upper airway and directly enter the lungs. A hollow tracheostomy tube is then inserted through this opening to keep the stoma open and maintain a clear pathway for breathing.
The outer cannula forms the main body of the tube. Inside the outer cannula, a removable inner cannula often fits. The tube also features a neck flange that rests against the patient’s neck, securing the tube in place with ties or a strap.
What is an Obturator?
An obturator is a component designed to assist with the insertion of a tracheostomy tube. It is a solid, rod-like device, with a smooth, rounded tip. This device is inserted into the outer cannula of the tracheostomy tube before insertion, extending slightly beyond the tube’s end. The obturator’s design helps to provide rigidity and a guiding surface for the tracheostomy tube.
The primary function of the obturator is to facilitate the safe and smooth passage of the tracheostomy tube through the stoma and into the trachea. Its rounded tip minimizes friction and helps navigate the anatomical structures without causing trauma. Once the tracheostomy tube is successfully positioned in the airway, the obturator is removed immediately, as it obstructs the tube’s lumen and prevents airflow.
How the Obturator is Used
The practical application of the obturator involves a precise sequence of steps during tracheostomy tube insertion or reinsertion. Before the procedure, the obturator is placed inside the outer cannula of the new tracheostomy tube.
When inserting the tracheostomy tube, the healthcare provider uses the obturator as a guide. The smooth, blunted tip of the obturator helps to gently dilate the stoma and guides the tube through the tissue layers and into the trachea, reducing the risk of tissue damage.
Importance of the Obturator
The obturator holds significant importance in tracheostomy care by contributing to patient safety and successful tube placement. Its use during insertion helps prevent potential complications such as damage to the tracheal wall, creation of a false passage, or bleeding. The smooth, rounded tip of the obturator protects the delicate tissues of the airway from the potentially sharp edges of the tracheostomy tube itself.
By guiding the tube accurately into the trachea, the obturator ensures proper and secure positioning, which is important for maintaining a patent airway. A well-placed tracheostomy tube allows for effective breathing and, if necessary, connection to mechanical ventilation. The obturator is considered an essential component that accompanies each tracheostomy tube, and it should always be kept readily available at the bedside for emergency reinsertion.