Tracheostomy Procedure
(Medical procedures and tests)
This page will help you understand tracheostomy and how to prepare for it.
What Is a Tracheostomy Procedure?
A tracheostomy, also called a tracheal stoma, is a surgical procedure to create an opening in the front of the trachea (windpipe) to facilitate breathing. The surgeon makes an incision through the front of the neck into the trachea and then inserts a tracheostomy tube into the opening to keep it open for breathing.
The tube provides an airway to help with breathing when the normal breathing pathway is blocked.
This procedure is often needed when health problems require long-term use of a breathing machine (ventilator). In rare cases, it is performed as an emergency when the airway becomes suddenly blocked, such as after a traumatic injury to the face or neck.
When Is a Tracheostomy Performed?
The surgical technique depends on whether the tracheostomy is performed as a medical emergency or not. When possible and safe, the procedure is performed under general anesthesia.
- Emergency tracheostomy: It is important to carry out the entire procedure as quickly as possible. The patient is placed on their back, and a rolled towel (or equivalent) is positioned under the shoulders to help extend the neck. Local anesthetic is injected into the targeted area. The surgeon then makes an incision in the skin to open the trachea, after which an airway tube is inserted and connected to an oxygen source. The entire procedure is performed as quickly as possible.
- Non-emergency tracheostomy: This procedure is usually performed under general anesthesia in an operating room. The patient is placed on their back, and the neck and chest are cleaned with an antiseptic. The incision is made in the lower half of the neck (between the larynx and the sternum). The skin of the throat is cut horizontally, the underlying muscles are separated, and an incision is made through the wall of the trachea. The tube is then inserted into the opening.
- Situations that may require a tracheostomy include:
- Medical conditions that require the use of a ventilator for a prolonged period, usually more than a week or two.
- Medical conditions that cause airway obstruction or narrowing, such as vocal cord paralysis or throat cancer.
Preparation for major head or neck surgeries to facilitate breathing during the healing process.
Paralysis, neurological problems, or other conditions that make it difficult to clear throat secretions by coughing or sneezing, and require direct suctioning of the trachea to keep the airway clear.
Severe traumatic injury to the head or neck that obstructs breathing.
Who Is at Risk?
A tracheostomy may be performed as an emergency in someone with a severe acute illness or traumatic injury blocking the airway, or in a person with a chronic condition that blocks the airway or paralyzes the breathing muscles.
How to Prepare for a Tracheostomy?
Preparation depends on the type of procedure.
If general anesthesia is planned, the doctor may ask the patient to avoid food and drink for several hours beforehand and to stop certain medications before the surgery.
Health Education Instructions
Your healthcare provider will give you postoperative instructions on caring for the wound and cleaning the tracheostomy tube.
It is important not to remove any visible stitches, to keep the wound clean and dry, and to cover it with adhesive dressings for the first one or two days after surgery.
Frequently Asked Questions:
Can I speak after the procedure?
Most tracheostomy tubes have an air-filled cuff around them, so you will not be able to speak when the cuff is inflated.
At first, you may need to communicate using writing or gestures. As you recover, air will gradually be removed from the cuff, allowing you to start speaking.
Sometimes a speaking valve can be attached to the tube to help make your voice stronger.
Can I eat and drink while the tube is in place?
- You may be able to eat and drink with a tracheostomy tube, but if you cannot swallow safely, you might need a thin feeding tube passed through your nose into your stomach to provide liquid food and fluids directly.
- When Will the Tube Be Removed?
- The tracheostomy tube will be removed when you no longer need help with breathing.
- This may take a few days or weeks, but some people need it for longer.
- After the tube is removed, a dressing will be placed over the hole, which usually heals within 7 to 10 days.
- You may feel some pain or discomfort where the tube was, but this should improve as the site heals.
- You will also have a small scar on your neck, which will fade over time.
- What Complications Require Medical Attention?
- Tracheostomy is generally safe, but some complications can occur during or shortly after surgery, especially if it was done as an emergency. Possible complications include:
- Bleeding at the stoma site or from the trachea.
