Tracheostomy - Information for Families (From Cleveland Clinic see..)

What is an endotracheal tube?
During surgery, an endotracheal tube (breathing tube) was inserted through the patientís mouth into the trachea (the large airway from the mouth to the lungs). The purpose of the endotracheal tube is to permit air to pass freely to and from the lungs from a mechanical ventilator (breathing machine). While it is in place, the patient is not able to talk or eat by mouth. In most cases, the endotracheal tube is removed in the intensive care unit when the patient is fully awake and breathing independently.

What does a trach tube look like?
Trach tubes come in several sizes and materials. The type of tube is dependent on the patientís condition, neck shape and size and purpose of the tracheostomy.

All trach tubes have an outer cannula (main shaft) and a neckplate (flange). Secretions are suctioned through the main shaft. The flange rests on the neck over the stoma (opening). There are holes on each side of the neckplate so ties can be used to secure the trach tube in place.


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 patientís 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 ďtrach.Ē 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 patientís 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 patientís 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.



What is a tracheostomy?

A tracheostomy is a hole in the neck that allows people to breathe. The hole goes directly into the trachea (windpipe) and connects to the lungs. This simple surgery is sometimes done as an emergency.

The terms tracheostomy and tracheotomy are often used the same way. Tracheotomy is the name for the operation, but tracheostomy refers to the actual opening in the neck.

Why does a tracheostomy need to be done?

There are several situations when someone might need a tracheostomy.

If someone is unable to breathe because of a facial injury or a throat blockage, an emergency tracheostomy is done to allow breathing.

In other cases, a hospital patient may need a ventilator (mechanical breathing machine, also known as a respirator) for a few weeks or longer. Usually, a plastic breathing tube comes from the mouth or nose and connects to the ventilator. Because the breathing tube could damage the mouth and throat over time (including the voice box), a tracheostomy may be done. By putting a hole directly in the neck, the mouth and throat can be left alone.

How is a tracheostomy performed?

After you're put to sleep (under general anesthesia), a surgeon makes a small cut in your neck. Another small cut is made in the trachea. Then a plastic tracheostomy tube is placed. There are many different types and sizes of tubes. The opening of the tube comes out of the neck, and a flexible strap goes around the neck and holds the tube in place.

The hole can be temporary or permanent. Surgery can be done to close the hole if it's no longer needed.

How long does the procedure take?

The surgery is short and usually takes less than an hour. In an emergency, it can be done in a few minutes.

What are the risks?

The operation is considered low risk, so major problems are rare. Bleeding and infection are possible at the incision. The risk of injury to other organs is very small.

Although a tracheostomy prevents you from speaking, there are caps and valves that can cover the opening of the tube so you can talk.