Master Tracheoesophageal Fistula (TEF) with Picmonic for Nursing RN

Esophageal atresia is a birth defect in which the esophagus does not develop properly, causing the esophagus to end in a blind pouch, rather than connecting to the stomach. Esophageal atresia can occur with or without a tracheoesophageal fistula.

Although there are several different types of esophageal atresia and tracheoesophageal fistula, the most common form occurs when the esophagus ends in a blind pouch instead of the stomach.

A newborn with this condition may cough frequently as secretions from the esophagus enter the trachea through the fistula or abnormal connection.

Newborns with a tracheoesophageal fistula have an abnormal connection between the trachea and esophagus, which allows food or liquid from the esophagus to enter the newborn’s airway. This malformation can cause choking.

A newborn with a tracheoesophageal fistula may become cyanotic, especially during/after a feeding due to aspiration of fluid into the lungs.

A newborn that presents with large amounts of frothy sputum, or drool, are suspected of having this condition.

Newborns who are suspected of having this condition are immediately made NPO, meaning that they cannot take anything by mouth - no breastfeeding and no formula. NPO precautions are initiated to prevent aspiration and to ensure that the newborn’s airway remains patent. Anticipate intravenous therapy to be initiated promptly.

Surgery is needed to correct the abnormality between the trachea and the esophagus. This is imminently needed in order for proper respiration and GI function.

Because there is an abnormal connection between the trachea and esophagus, food or liquids from the esophagus can enter the patient’s airway. Aspiration of food or fluids into the lungs may lead to aspiration pneumonia. Position infant supine with the head of the bed elevated on an inclined plane of at least 30 degrees.