Tracheotomy

What you should know

  • A tracheotomy is a surgery done to help you breathe through an opening in your trachea. The trachea is the tube that runs down inside the front part of your neck. The air you breathe passes from your nose or mouth, down your trachea, and into your lungs. The lungs then deliver the oxygen taken from the air to your blood and body organs. You may need this surgery if you are very sick and need long-term help with your breathing. You may need this surgery if you have a disease that damages the muscles used in breathing. You may also need a tracheotomy if you cannot clear the mucous out of your airways. This surgery may also be done if you need emergency breathing help from an injury.

  • With a tracheotomy, a cut or a small hole is made in your neck and trachea. A plastic or metal tube, also called a trach, is put into the incision or hole. This tube may be connected to a breathing machine to help draw air into your lungs. The tracheotomy may also be used to suction out phlegm that may be blocking your airways. Having a tracheotomy may decrease your breathing problems and improve the oxygen levels in your body.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During your surgery, you may have too much bleeding and your vital signs may be unstable. You may get an infection in the area of the cut. Air may get trapped under your skin through the opening in your neck. You may have trouble breathing if the tube in your trachea is blocked by blood clots or phlegm. The trach tube may come out on its own, making it hard for you to breathe. Caregivers will watch you closely for early signs of these problems.

  • You may get a lung infection or have trouble swallowing after surgery. Your trachea may narrow and decrease the amount of air getting into your lungs. The tube in your neck may also rub on your trachea or the blood vessels in your neck. This could make an abnormal hole that bleeds or allows food and fluid to get into your lungs. Your body may react to the trach tube by forming tissue lumps around or near the opening. If you do not have the surgery, you may continue to have increased trouble breathing. Body organs, such as your heart and brain may not function well from a lack of oxygen. Call your caregiver if you are worried or have questions about your medicine or care.

Getting Ready

Before your surgery:

  • You may be given antibiotic medicine before your procedure to prevent an infection. Talk to your caregiver about what medicines you should or should not take before your surgery.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Write down the correct date, time, and location of your surgery.

Treatment

What will happen:

  • You may be given medicine in your IV to help you relax or make you drowsy. You may get general anesthesia to keep you completely asleep, or local anesthesia that will numb your neck. A caregiver will clean your neck area with a special soap. Your caregivers will monitor your heart rate, breathing, blood pressure, oxygenation, and level of sedation.

  • A small incision will be made in front of your neck, and another in your trachea. Your caregiver will make sure that your thyroid gland, neck muscles, and blood vessels are not damaged. Your caregiver may also use a needle to put a small hole into your trachea instead of an incision. He will then place a guidewire into your trachea and widen the hole using special tools. He may use a bronchoscope which is a tube with a light and tiny camera on the end. This will take pictures of the inside of your airways that can be seen on a TV-like screen. A metal or plastic tube will then be inserted into the cut or hole in your neck.

After your surgery:

The tracheotomy tube may be connected to a breathing machine to help you breathe. Caregivers will suction out any phlegm, and continue to monitor your vital signs. Caregivers will do trach care to keep your new tracheotomy area clean and dry. Your trach tube has an inflated cuff that helps decrease any air leaks and keeps it secure. Your caregiver may check the cuff pressure often to ensure it is not so full that it harms your trachea. Do not get out of bed until your caregiver says it is OK. You may be asked to sit in a chair after you are fully awake. Any activity after your surgery will be for short time periods and increase as you become stronger.

Contact a caregiver if

  • You cannot make it to your surgery on time.

  • You get sick (a cold or flu) or have a fever.

  • You have questions about your surgery, treatment, or care.

Seek Care Immediately if

  • You have more trouble breathing than usual.

  • You suddenly have chest pain.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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