Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A tracheostomy is a surgically created opening in the neck leading directly to the trachea (the breathing tube). It is maintained open with a hollow tube called a tracheostomy tube.
Why is a tracheostomy performed?
A tracheostomy is usually done for one of three reasons: (1) to bypass an obstructed upper airway (an object obstructing the upper airway will prevent oxygen from the mouth to reach the lungs); (2) to clean and remove secretions from the airway; and (3) to more easily, and usually more safely, deliver oxygen to the lungs.
What are risks and complications of tracheostomy?
It is important to understand that a tracheostomy, as with all surgeries, involves potential complications and possible injury from both known and unforeseen causes. Because individuals vary in their tissue circulation and healing processes, as well as anesthetic reactions, ultimately there can be no guarantee made as to the results or potential complications. Tracheostomies are usually performed during emergency situations or on very ill patients. This patient population is, therefore, at higher risk for a complication during and after the procedure
The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. It is listed here for information only in order to provide a greater awareness and knowledge concerning the tracheostomy procedure.
Bleeding. In very rare situations, the need for blood
products or a
blood transfusion.
Damage to the larynx (voice
box) or airway with resultant permanent change in voice (rare).
Need for further and more aggressive surgery
Infection
Air trapping in the surrounding tissues or chest. In
rare situations, a chest tube may be required
Scarring of the airway or erosion of the tube into
the surrounding structures (rare).
Need for a permanent tracheostomy. This is most
likely the result of the disease process which made the a tracheostomy
necessary, and not from the actual procedure itself.
Impaired swallowing and vocal function
Scarring of the neck
Obviously, many of the types of patients who undergo a
tracheostomy are
seriously ill and have multiple organ-system problems. The
doctors will
decide on the ideal timing for the tracheostomy based on the
patient's
status and underlying medical conditions.
Malignant hyperthermia is a severe reaction to particular drugs that are often used during general anesthesia for surgery.
Malignant hyperthermia occurs in 1 in 5,000 to 50,000 instances in which people are given anesthetic gases.
Muscle rigidity, breakdown of muscle fibers (rhabdomyolysis), a high fever, increased acid levels in the blood and other tissues (acidosis), and a rapid heart rate are some of the effects of this potentially life-threatening condition.
Researchers have described at least six forms of malignant hyperthermia susceptibility, which are caused by mutations in different genes. For example, variations of the CACNA1S and RYR1 genes increase the risk of developing malignant hyperthermia.
Malignant hyperthermia susceptibility is inherited in an autosomal dominant manner (which means that one c...
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