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Tracheotomy—Adult

(Tracheostomy)

Definition

Tracheotomy is the surgical creation of an opening from the outside of the neck into the windpipe. A tube is inserted into the opening to allow for normal breathing.
Tracheostomy
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Reasons for Procedure

A tracheotomy is done to bypass obstructions that are interfering with breathing. The opening is called a stoma or tracheostomy. A stoma may be either temporary or permanent.
A tracheotomy is done to restore normal breathing in the following situations:

Possible Complications

If you are planning to have a tracheotomy, your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Chest x-ray
  • Blood and urine tests
  • Review of medications
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Anesthesia

General anesthesia will be used. You will be asleep. In emergency situations, local anesthesia may be used. It will numb the area.

Description of Procedure

A cut will be made in the skin of the neck. A section at the front of the windpipe will be removed. A tracheostomy tube, which will act as the airway, will then be fitted into this opening in the windpipe. The skin will be closed around the tube with stitches or clips.

Immediately After Procedure

You will breathe through this tube as long as it is in place. Oxygen and machines to assist breathing will be provided, if needed. A chest x-ray may be needed.

How Long Will It Take?

About 15-30 minutes

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. You may have some pain and soreness during recovery. Your doctor can prescribe pain medication to help relieve this discomfort.

Average Hospital Stay

The length of stay will depend on the reason for the procedure. Most stays are 1-5 days.

Post-procedure Care

Tracheostomy tubes need to be cared for on a regular basis. The hospital staff will teach you how to care for your tracheostomy tube. It is important follow the staff’s instructions to prevent infection and airway obstruction. Other specialists will help you adjust to the tracheotomy and learn how to speak and eat with the tracheostomy.
Tracheostomy tube care considerations include:
  • Regular cleaning
  • Regular clearing of secretions
  • Keeping the airway open
  • How to use oxygen or a humidifier (if needed)
  • Learning to keep away from irritants that affect the airway
  • Speaking and eating techniques
  • Learning cardiopulmonary resuscitation (CPR)
  • Knowing when to call for emergency medical services

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
Call for emergency medical services right away if:
If you think you have an emergency, call for medical help right away.

RESOURCES

American Lung Association http://www.lung.org

National Heart Lung and Blood Institute http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Medical Association http://www.cma.ca

The Lung Association http://www.lung.ca

References

Caring for your tracheotomy. University of Miami Health System website. Available at: http://calder.med.miami.edu/pointis/traccare.html. Accessed September 17, 2013.

Frequently asked questions about tracheotomy and swallowing. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/slp/clinical/frequently-asked-questions-on-tracheotomy-and-swallowing. Accessed September 17, 2013.

Tracheostomy (putting a breathing tube through a small hole in the throat). American Thoracic Society website. Available at: http://www.thoracic.org/clinical/critical-care/patient-information/icu-devices-and-procedures/tracheostomy-putting-a-breathing-tube-through-a-small-hole-in-the-throat.php. Accessed September 17, 2013.

What is a tracheostomy? Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/tracheostomy/about/what.html. Accessed September 17, 2013.

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