It is rather difficult to predict precisely the effects of electrical energy on tissue and that too in a clinical settting because of the variables (both known and unknown) involved. The effects caused by electrosurgery is due to the heat generated within the tissue by an external source of energy. Since high frequency alternating current is used there is no net transfer of electrons and also there is no movement of ions across cell membranes (depolarization). In cauterization the heat is derived from an external source and transmitted to the tissue by conductance.
It is hard to speak with a tracheostomy tube in situ. There are certain tracheostomy tube accessories that enables the patient to speak with the tube in place. One such accessory is the speaking valve. It is a button like equipment placed on the outer hub of the tracheostomy tube. These valves are one-way valves that can be attached to the outer end of the tracheostomy tube. These valves allow air to enter through the tube and exit through the mouth and nose.
This is a bayonet shaped instrument with a very sharp trocar like tip. The tip is guarded at some distance to ensure that the tip does not prevent too deep into the tissue. In quinsy drainage the sharp tip is used to pierce the bulge of the swelling with the forceps in closed position. Then after successful piercing it is opened like a sinus forceps to facilitate drainage of pus.
Tracheostomy happens to be an old surgical procedure. Description of this procedure could be seen in old Egyptian tablets dating back to 3600 BC. Asclepiades of Persia has been credited with the first tracheostomy way back in 100 BC.