ARRT Patient Care Practice Exam

In which situation would a tracheostomy be considered?

1. If the patient shows no signs of respiratory distress

2. If obstruction occurs above the carina

3. If there is laryngeal cancer

4. If the airway is obstructed below the level of the larynx

The correct answer is: If the airway is obstructed below the level of the larynx

In the context of tracheostomy, it is primarily considered when a patient's airway needs to be secured due to potential or existing obstructions. When there is an obstruction below the level of the larynx, a tracheostomy offers a direct airway access point, bypassing whatever is causing the obstruction. This procedure can be especially crucial in emergency situations or chronic conditions where the normal airway is compromised. Obstructions below the larynx can arise from various causes, including trauma, swelling, foreign bodies, or certain medical conditions that impede airflow through the trachea. A tracheostomy effectively provides ventilation and accessibility for breathing in these scenarios, ensuring adequate oxygen delivery and reducing the risk of respiratory failure. In contrast, a tracheostomy would not be indicated if there are no signs of respiratory distress, as the procedure is typically reserved for managing clear airway emergencies. Similarly, while laryngeal cancer can indeed lead to airway obstruction, the need for a tracheostomy is context-dependent on the specific circumstances of each case. Therefore, the placement of a tracheostomy can be a life-saving intervention in situations where obstruction is present below the larynx.