Tracheotomy

What is a tracheotomy?

A tracheotomy is a surgical procedure that creates an opening in your neck and windpipe (trachea). A tube is then placed in the opening to keep it open. The procedure helps get air to your lungs.

The terms tracheotomy, tracheostomy, and trach may be used to refer to both the surgical procedure and to the opening created by the procedure.

When is it used?

A tracheotomy may be done when you have a problem with your airway. If the upper airway is blocked, a tracheotomy can bypass the blockage to provide airflow to your lungs. It is also used to provide oxygen to the lungs more efficiently and to clear secretions from the airway.

Examples of when you might need a tracheotomy are:

• Your upper airway is blocked by swelling or a tumor.
• You will be on a breathing machine (ventilator) for a long time.
• You have lots of saliva that you cannot get rid of and so you need frequent suctioning of your airway.

What happens during the procedure?

A tracheotomy is usually done in an operating room or in an intensive care unit. Your heart and oxygen levels are monitored during the procedure.

First you are given an anesthetic. The anesthetic should keep you from feeling pain during the procedure. Then the surgeon makes a cut (incision) in your neck and trachea in the area of the neck below the Adam's apple and voice box (larynx). A tube is placed in the opening. The tube is held in place with a band or laces around the neck.

What happens after the procedure?

The tracheotomy site will begin to heal and your surgeon will monitor you for a few days. The original tube is usually kept in place for 5 to 10 days. After that a new tube may be used.

If you are on a ventilator, the tube will have a balloon around it that prevents air from leaking. In this case you will not be able to talk. If you do not need a ventilator, a smaller tube may be used that allows air to pass around it. In this case you may be able to talk.

When you no longer need the tracheotomy, your surgeon will remove the tube and close the opening in your neck.

What are the complications?

Possible complications of a tracheotomy are:

• bleeding
• infection
• damage to the voice box (larynx)
• difficulty swallowing
• scarring.

How do I care for a tracheotomy?

If you still have the tracheotomy when you go home from the hospital, you or your family will be taught how to care for the tracheotomy. This will include cleaning the trach site, suctioning, and changing the tube.

You may have an inner cannula (tube) that fits into the outer tube of the tracheotomy. This inner tube helps keep secretions such as mucus out of the tracheotomy so your breathing isn't blocked. You need to clean this tube at least once a day. The basic steps for cleaning the tube are:

1. Wash your hands with soap and warm water.
2. Remove the inner cannula from the trach tube.
3. Use hydrogen peroxide and a trach brush or soft pipe cleaner to clean the inner cannula and remove secretions. You may need to soak the cannula first in hydrogen peroxide for a few minutes if it is very dirty.
4. Rinse the inner cannula thoroughly with tap water.
5. Shake excess water from the cannula.
6. Put the clean inner cannula back in place as soon as you are done cleaning it. Lock it in place.