Tracheostomy is a surgical procedure used to create an opening in the neck into the windpipe to allow the patient to breathe. Generally, a tube will be inserted through the opening to provide an airway, to allow for the removal of secretions from the lungs, and to provide airway management. The term tracheostomy tube or trach tube applies to this airway device. The tracheostomy procedure is typically done under general anesthesia.
Reasons for Performing a Tracheostomy
- Blockage of the airway
- Abnormality of the larynx or trachea
- Damage from smoke, steam, or other toxic gases
- Paralysis of the muscles that affect swallowing.
- Injuries of the neck or mouth
A tracheostomy may be temporary; if so, the trach tube will be removed when it is no longer needed. Only a minimal scar will remain after healing, which generally occurs in a few weeks. Sometimes the area will tighten and cause breathing difficulty and will need further surgery. On the other hand, if the tube is permanent, the hole will remain open. If it is no longer needed, the hole left by the tracheostomy procedure may be surgically closed.
At first, breathing is a learning process. Also, communicating with others will not happen overnight. It will take some time. Given training and practice, most can learn to talk even with the hole still open and the tube in. Patience is required of the patient as well as the caregivers while all of this adjustment occurs.
The patient and the caregiver(s) must learn how to take care of the tracheostomy. Hospital personnel should provide training and home-care service may be required.
Medical professionals feel that a normal lifestyle should be pursued by the tracheostomy patient. However, when the patient goes outdoors, the hole should be covered lightly such as with a scarf. Care will need to be taken with regard to safety precautions such as exposure to water, powder, or food particles. Several manufacturers produce tracheostomy accessories to help provide safety precautions to protect the health of the trach patient. These trach accessories include the trach vent, passey valve, trach shower shield, soma shield cover, trach collar, trach ties, trach tube holder, trach cover, trach heat exchanger, tracheostomy cleaning tray, and trach speaking valve.
Changing the Tube
The tracheostomy tube will need to be changed from time to time, but the surgeon will do the first one. This will happen usually a couple of weeks after surgery, and the medical team will teach caregivers how to change the tube.
The inside of the trach tube will be coated with secretions from the lungs and so it needs to be changed about once a week. Should the patient have a chest infection, the tube may need to be changed oftener. Timing is important. It should be done before a meal or at least two hours after a meal.
The air coming through the tracheostomy tube is cooler, dryer, and not as clean as that breathed normally. The body responds by producing more mucus. Suctioning is vital! The purpose is to clean the mucus from the tube so breathing will not be obstructed. If secretions are left in the trach tube, they may lead to a chest infection. Try to work out a practical schedule for suctioning. If you do it too often, it will simply lead to more secretion buildup.
Many people live for years with tracheostomies and have normal lives, both older and younger people. Patience on the part of the person with the tracheostomy as well as those around him or her will make it possible to get through the difficulties until they become a little-noticed part of your family’s daily existence.