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Protection of the tracheo-bronchial tree is required when there is pharyngeal or laryngeal incompetence which may cause aspiration of food, saliva, blood or gastric contents.
Endotracheal intubation is appropriate for conditions that are only of a short duration e.g. general anaesthesia.
Tracheostomy is indicated in chronic conditions as it allows easy access to the trachea and bronchi for regular suction, and permits the use of a cuffed tube which further protects against aspiration.
Tracheostomy should be considered in conditions such as:
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