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Reasons for Procedure
The airway is obstructed at or above the level of the larynx, which is also known as the voice box, due to:
- Trauma to the neck area
- Obstructing tumors in the upper airway
- Vocal cord paralysis
- Removal of larynx for throat cancer
Respiratory failure requiring long-term mechanical breathing assistance, as in these cases:
- Spinal cord injury in the neck area
- Severe lung infection or inflammation
- If you have been on a ventilator for 21 days
- Injury to the respiratory tract due to breathing in smoke or steam or inhaling corrosive substances
- Birth defects of the trachea or larynx
- Foreign object blocking the trachea or larynx
- Severe sleep apnea
- Damage to the vocal cords, vocal cord nerves, or esophagus
- Damage to the lungs
- Difficulty swallowing
- Air trapped in tissue under the skin of the neck
- Low blood pressure
- Tracheostomy tube displacement or damage
- Scarring at the site of operation leading to closure of the tracheostomy or tracheal narrowing
- Abnormal connection to esophagus or surrounding blood vessels
What to Expect
Prior to Procedure
- Chest x-ray
- Blood and urine tests
- Review of medications
- Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen
- Blood-thinning medications
- Anti-platelet medications
Description of Procedure
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Keep the stoma area and incision clean and dry. Clean it daily with mild soap and water or with hydrogen peroxide.
- Wash your hands before changing the dressing. Replace the dressing with a clean dry one.
- Ask your doctor about when it is safe to shower, bathe, or soak in water. You may be advised not to get water on the stoma.
Learn the proper daily
care of your tracheostomy tube
. This will help maintain its long-term health and function. Care includes the following, which you will be taught shortly after the surgery:
- You will need to learn removal and replacement of the tube if it becomes blocked or dislodged.
- Proper cleaning of the tube
- Suctioning the tube regularly to keep it from becoming blocked with secretions
- Apply mist through your tracheotomy tube at least during the night to prevent blockage of the tube
- Covering the tracheostomy hole with a scarf or other cloth when going outside, so that dust, dirt, and other foreign particles cannot get in
- Being very cautious about breathing in water or small particles through the tracheostomy such as food bits, powders, aerosol sprays, dust
- Consult a speech therapist if recommended by your doctor.
- Take antibiotics, if prescribed by your doctor.
- Return to daily activities and work as soon as possible to promote healing.
- Avoid vigorous exercise for six weeks after surgery.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
- Signs of infection, including cough, excessive foul-smelling mucous, fever, and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medications you have been given
- Cough, shortness of breath, or chest pain
- New, unexplained symptoms
- Your tracheostomy tube falls out and you can't replace it
- You are having difficulty breathing through your tube
American Lung Association http://www.lungusa.org
National Heart Lung and Blood Institute http://www.nhlbi.nih.gov
Canadian Medical Association http://www.cma.ca
The Lung Association http://www.lung.ca
Caring for your tracheotomy. University of Miami Health System website. Available at: http://calder.med.miami.edu/pointis/traccare.html . Accessed September 17, 2013.
Frequently asked questions about tracheotomy and swallowing. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/slp/clinical/frequently-asked-questions-on-tracheotomy-and-swallowing/ . Accessed September 17, 2013.
Tracheostomy (putting a breathing tube through a small hole in the throat). American Thoracic Society website. Available at: http://www.thoracic.org/clinical/critical-care/patient-information/icu-devices-and-procedures/tracheostomy-putting-a-breathing-tube-through-a-small-hole-in-the-throat.php . Accessed September 17, 2013.
What is a tracheostomy? Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/tracheostomy/about/what.html . Accessed September 17, 2013.
- Reviewer: Michael Woods, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -