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• A tracheostomy is a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. This tube is called a tracheostomy tube or trach tube. • • • • • • • • • • Why the Procedure is Performed A tracheostomy may be done if you have: A large object blocking the airway An inability to breathe on your own An inherited abnormality of the larynx or trachea Breathed in harmful material such as smoke, steam, or other toxic gases that swell and block the airway Cancer of the neck, which can affect breathing by pressing on the airway Paralysis of the muscles that affect swallowing Severe neck or mouth injuries Surgery around the voicebox (larynx) that prevents normal breathing and swallowing FRESH WATER DROWNING • Heamodilution and overloadingof heart with heamolysis and release of k in circulation result in hypercalamia ventricular fibrillation and death SALT WATER DROWNING • Water enter in lungs then drawn from lungs into blood and pulmonary circulation due to osmotic pressure effect which result in edema of lungs heamodilution ciculatrey shock cardiac systole (stand still) and death CLASSIFICATION OF DROWNING • 1-TYPICAL OR WET DROWNING( Obstruction to air passage by water or fluid) • 2-ATYPICAL DROWNING-Very little or no water inhaled into the air passage TYPE OF ATYPICAL DROWNING • 1-Dry drowning2-Imerssion syndrome3-Submerssion of unconscious4-Secondrey drowning