True about pediatric tracheostomy – a) Most common early complication is subcutaneous emphysemab) 3rd & 4th tracheal rings are incisedc) Easy to remove the tracheostomy tubed) Complete tracheal ring is removede) Moisturing of orifice should be done
Pediatric treacheostomy

In most of the cases tracheostomy is performed with general anesthesia and the patient intubated and paralyzed.
Neck is extended.
A horizontal incision is made halfway between the cricoid cartilage and the sternal notch.
Subcutaneous fat and tissues are reflected, and deep cervical facia, is cut to expose thyroid isthmus.
A vertical cut is given in 2-3 or 3-4 rings in midline and no part of the tracheal wall is removed.
The endotracheal tube is withdrawn and a suitable size tracheostomy tube is simultaneously inserted.
Post-operatively neck & chest radiograph are obtained to evaluate the position of the tube and to identify the subcutaneous emphysema & pneumothorax that could have developed as complication.
Tube must be cleaned at frequent intervals.
Patient should be nursed in and atmosphere of moist air.
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