Understanding the Basics of Tracheostomy: What You Need to Know

Understanding Its Definition

What is it?

What's a Tracheostomy?

A tracheostomy is basically a surgery where they make a little opening in your windpipe (that’s the trachea). This is usually done when someone needs to be on a ventilator for a long time, has trouble swallowing, or can’t clear out mucus from their airways. Depending on what’s going on, it can be done in an emergency or planned ahead of time.

One thing to keep in mind is that when the tube is in place, air doesn’t go through the vocal cords, so the person won’t be able to talk. But don’t worry—once the tube is taken out, they can chat again!

What is the aim of the procedure?

The goal of the procedure is to make an opening in the trachea. This lets us bypass the upper airway, giving another way for air to get through and clear out secretions. The cuff on the tube helps keep food and saliva from getting into the lower airway/lungs. 

What is done during the procedure?

During the procedure, a tracheostomy tube of appropriate size and material is inserted through an incision in the trachea. The choice of anesthesia—either local anesthesia or monitored anesthetic care—depends on the patient's condition and level of comfort.

What are the risks associated with the procedure?

• Bleeding can occur from the stoma site, especially when the patient is on blood thinners. 

• Infection of the stoma site can occur.

• Air may get trapped in the layer under the skin.

• Injury to the lung may result in air getting collected around the lung, which may necessitate the insertion of an inter-costal tube to drain the air.

• Injury to the oesophagus.

• Obstruction of the tube.

In the long term the following complications can occur:

• Narrowing of the trachea.

• An abnormal communication between the trachea and oesophagus which leads to persistent aspiration.

• An abnormal communication can occur between the trachea and the blood vessels of the neck leading to bleed.

• Recurrent lung infection can occur.

  
  

Post-operative care and follow-up:

The tracheostomy tube requires daily care to prevent complications associated with it. For detailed instructions on tracheostomy tube care please refer the pamphlet.