What is a tracheostomy and why is it needed?
In some cases, the patient may need to be supported longer than expected with mechanical ventilation. The patient may not be able to effectively remove secretions from the lungs. Doctors may suggest taking the breathing tube out of the patient’s mouth and passing a tube through a small opening or incision made in the throat, called a tracheostomy. Instead of breathing through the nose and mouth, the patient then breathes through the tracheostomy or “trach.” The tracheostomy procedure can be done in the operating room or in the intensive care unit.
The tracheostomy tube is more comfortable for the patient than the endotracheal tube in the mouth.
A tracheostomy can more easily and more safely deliver oxygen to the lungs, and will allow a health care provider to clear secretions from the patient’s breathing passages.
A tracheostomy may help speed the process of weaning the patient off the ventilator. The tracheostomy can be taken out when the patient is able to breathe well without the help of a ventilator.
How will my family member communicate and eat?
Immediately after the tracheostomy and while the patient requires breathing assistance from the mechanical ventilator, he or she will not be able to talk or eat by mouth.
Usually, the patient will be fed through a small tube that delivers nutrition directly into the stomach. The patient will communicate with others by writing and by shaking or nodding a response when questions are asked. The registered nurse will help you find the best way to communicate with your family member.
Will my family member be in pain?
It is normal for the patient to feel some pain and discomfort for about a week. Pain medications will be given.
The tracheostomy area will be monitored closely after the procedure to watch for signs of infection and to evaluate healing. You may see the registered nurse and respiratory therapist remove secretions from the trach tube by using a suction tube. This help keeps the breathing passages clear. For the first few days after the tracheostomy, the secretions may be bloody. This is normal and expected.
Is the tracheostomy permanent?
The tracheostomy is not necessarily permanent. The patient’s condition and purpose of the tracheostomy will determine when and if the trach tube can be removed. Our goal is to help the patient recover as quickly as possible so mechanical ventilation can be discontinued at the earliest and safest possible time. If the trach tube will remain in place after the patient is discharged from the hospital, a nurse will teach the patient and family members the proper way to care for the trach tube.
What are the risks of the tracheostomy procedure?
As with all surgeries, there are risks involved with the tracheostomy procedure. Every effort is made to reduce the risk of complications. Complications are rare but may include bleeding, damage to the larynx or airway with a permanent change to the voice, need for further surgery, infection, scarring of the airway or neck, or impaired swallowing function. If the tracheostomy is not being performed as an emergent procedure, the health care providers will discuss the risks and benefits with the family members.