Definition A tracheostomy is a surgical procedure in which an opening is made through the neck into the windpipe or trachea. A tube is usually placed through this opening to provide an airway. This also allows for removal of secretions from the lungs.
Who is a candidate for the procedure? Indications for this procedure include:
an abnormality of the larynx or trachea present at birth
paralysis of the muscles that affect swallowing, which can occur with strokes or neuromuscular disorders such as muscular dystrophy
long-term unconsciousness or coma
How is the procedure performed? If time permits, the person is taken to the operating room. The person will be given medication to make him or her sleepy. Many times, this is a life-saving procedure, and there is not time to take the person to the operating room. The procedure may be done in the emergency department. The neck is cleaned and sterile towels are applied. A surgical cut is made to expose the tough cartilage rings that make up the outer wall of the trachea. Two of these rings are cut, and a tube is inserted.
What happens right after the procedure? After the procedure:
the tube will be tied in place using a special type of string
the muscle and skin will be brought back together with stitches
a sterile gauze dressing will be applied
the person will not be able to talk while the tube is in place. It is important to have a paper and pencil for the person to write on after awakening.
depending on the reason for the tracheostomy, the person may be attached to an artificial breathing machine, or ventilator
frequent suctioning down the tracheostomy tube will be necessary to remove secretions
What happens later at home? Occasionally the person will be discharged with the tube in place. They will need instruction on the care of their tracheostomy tube before leaving the hospital. Visiting nurses may be needed initially.
What are the potential complications after the procedure? The following are potential complications following a tracheostomy:
mediastinal emphysema, or air under the tissue of the chest
ejection of the tracheostomy tube when the person coughs. This complication can be prevented by properly securing the tube in place.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
