Tracheotomy





Definition

A tracheotomy is a surgical procedure that opens up the windpipe (trachea). It is performed in emergency situations, in the operating room , or at bedside of critically ill patients. The term tracheostomy is sometimes used interchangeably with tracheotomy. Strictly speaking, however, tracheostomy usually refers to the opening itself while a tracheotomy is the actual operation.


Purpose

A tracheotomy is performed if enough air is not getting to the lungs, if the person cannot breathe without help, or is having problems with mucus and other secretions getting into the windpipe because of difficulty swallowing. There are many reasons why air cannot get to the lungs. The windpipe may be blocked by a swelling; by a severe injury to the neck, nose, or mouth; by a large foreign object; by paralysis of the throat muscles; or by a tumor. The patient may be in a coma, or need a ventilator to pump air into the lungs for a long period of time.


Demographics

Emergency tracheotomies are performed as needed in any person requiring one.


Description

Emergency tracheotomy

There are two different procedures that are called tracheotomies. The first is done only in emergency situations and can be performed quite rapidly. The emergency room physician or surgeon makes a cut in a thin part of the voice box (larynx) called the cricothyroid membrane. A tube is inserted and connected to an oxygen bag. This emergency procedure is sometimes called a cricothyroidotomy .

Surgical tracheotomy

The second type of tracheotomy takes more time and is usually done in an operating room. The surgeon first makes a cut (incision) in the skin of the neck that lies over the trachea. This incision is in the lower part of the neck between the Adam's apple and top of the breastbone. The neck muscles are separated and the thyroid gland, which overlies the trachea, is usually cut down the middle. The surgeon identifies the rings of cartilage that make up the trachea and cuts into the tough walls. A metal or plastic tube, called a tracheotomy tube, is inserted through the opening. This tube acts like a windpipe and allows the person to breathe. Oxygen or a mechanical ventilator may be hooked up to the tube to bring oxygen to the lungs. A dressing is placed around the opening. Tape or stitches (sutures) are used to hold the tube in place.

After a nonemergency tracheotomy, the patient usually stays in the hospital for three to five days, unless there is a complicating condition. It takes about two weeks to recover fully from the surgery.


Diagnosis/Preparation

Emergency tracheotomy

In the emergency tracheotomy, there is no time to explain the procedure or the need for it to the patient. The patient is placed on his or her back with face upward (supine), with a rolled-up towel between the shoulders. This positioning of the patient makes it easier for the doctor to feel and see the structures in the throat. A local anesthetic is injected across the cricothyroid membrane.


Nonemergency tracheotomy

In a nonemergency tracheotomy, there is time for the doctor to discuss the surgery with the patient, to explain what will happen and why it is needed. The patient

For a tracheotomy, an incision is made in the skin just above the sternal notch (A). Just below the thyroid, the membrane covering the trachea is divided (B), and the trachea itself is cut (C). A cross incision is made to enlarge the opening (D), and a tracheostomy tube may be put in place (E). (Illustration by GGS Inc.)
For a tracheotomy, an incision is made in the skin just above the sternal notch (A). Just below the thyroid, the membrane covering the trachea is divided (B), and the trachea itself is cut (C). A cross incision is made to enlarge the opening (D), and a tracheostomy tube may be put in place (E). (
Illustration by GGS Inc.
)
is then put under general anesthesia. The neck area and chest are then disinfected and surgical drapes are placed over the area, setting up a sterile surgical field.


Aftercare

Postoperative care

A chest x ray is often taken, especially in children, to check whether the tube has become displaced or if complications have occurred. The doctor may prescribe antibiotics to reduce the risk of infection. If the patient can breathe without a ventilator, the room is humidified; otherwise, if the tracheotomy tube is to remain in place, the air entering the tube from a ventilator is humidified. During the hospital stay, the patient and his or her family members will learn how to care for the tracheotomy tube, including suctioning and clearing it. Secretions are removed by passing a smaller tube (catheter) into the tracheotomy tube.

It takes most patients several days to adjust to breathing through the tracheotomy tube. At first, it will be hard even to make sounds. If the tube allows some air to escape and pass over the vocal cords, then the patient may be able to speak by holding a finger over the tube. Special tracheostomy tubes are also available that facilitate speech.

The tube will be removed if the tracheotomy is temporary. Then the wound will heal quickly and only a small scar may remain. If the tracheotomy is permanent, the hole stays open and, if it is no longer needed, it will be surgically closed.


Home care

After the patient is discharged, he or she will need help at home to manage the tracheotomy tube. Warm compresses can be used to relieve pain at the incision site. The patient is advised to keep the area dry. It is recommended that the patient wear a loose scarf over the opening when going outside. He or she should also avoid contact with water, food particles, and powdery substances that could enter the opening and cause serious breathing problems. The doctor may prescribe pain medication and antibiotics to minimize the risk of infections. If the tube is to be kept in place permanently, the patient can be referred to a speech therapist in order to learn to speak with the tube in place. The tracheotomy tube may be replaced four to 10 days after surgery.

Patients are encouraged to go about most of their normal activities once they leave the hospital. Vigorous activity is restricted for about six weeks. If the tracheotomy is permanent, further surgery may be needed to widen the opening, which narrows with time.


Risks

Immediate risks

There are several short-term risks associated with tracheotomies. Severe bleeding is one possible complication. The voice box or esophagus may be damaged during surgery. Air may become trapped in the surrounding tissues or the lung may collapse. The tracheotomy tube can be blocked by blood clots, mucus, or the pressure of the airway walls. Blockages can be prevented by suctioning, humidifying the air, and selecting the appropriate tracheotomy tube. Serious infections are rare.


Long-term risks

Over time, other complications may develop following a tracheotomy. The windpipe itself may become damaged for a number of reasons, including pressure from the tube, infectious bacteria that forms scar tissue, or friction from a tube that moves too much. Sometimes the opening does not close on its own after the tube is removed. This risk is higher in tracheotomies with tubes remaining in place for 16 weeks or longer. In these cases, the wound is surgically closed. Increased secretions may occur in patients with tracheostomies, which require more frequent suctioning.


High-risk groups

The risks associated with tracheotomies are higher in the following groups of patients:

  • children, especially newborns and infants
  • smokers
  • alcoholics
  • obese adults
  • persons over 60
  • persons with chronic diseases or respiratory infections
  • persons taking muscle relaxants , sleeping medications, tranquilizers, or cortisone

Normal results

Normal results include uncomplicated healing of the incision and successful maintenance of long-term tube placement.


Morbidity and mortality rates

The overall risk of death from a tracheotomy is less than 5%.


Alternatives

For most patients, there is no alternative to emergency tracheotomy. Some patients with pre-existing neuromuscular disease (such as ALS or muscular dystrophy) can be sucessfully managed with emergency noninvasive ventilation via a face mask, rather than with tracheotomy. Patients who receive nonemergency tracheotomy in preparation for mechanical ventilation may often be managed instead with noninvasive ventilation, with proper planning and education on the part of the patient, caregiver, and medical staff.


Resources

BOOKS

Bach, John R. Noninvasive Mechanical Ventilation. NJ: Hanley and Belfus, 2002.

Fagan, Johannes J., et al. Tracheotomy. Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., 1997.

"Neck Surgery." In The Surgery Book: An Illustrated Guide to 73 of the Most Common Operations , ed. Robert M. Younson, et al. New York: St. Martin's Press, 1993.

Schantz, Nancy V. "Emergency Cricothyroidotomy and Tracheostomy." In Procedures for the Primary Care Physician , ed. John Pfenninger and Grant Fowler. New York: Mosby, 1994.

OTHER

"Answers to Common Otolaryngology Health Care Questions." Department of Otolaryngology–Head and Neck Surgery Page. University of Washington School of Medicine [cited July 1, 2003]. http://weber.u.washington.edu/~otoweb/trach.html .

Sicard, Michael W. "Complications of Tracheotomy." The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences. December 1, 1994 [cited July 1, 2003]. http://http:www.bcm.tmc.edu/oto/grand/12194.html .


Jeanine Barone, Physiologist Richard Robinson

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?



Tracheotomy is performed by a surgeon in a hospital.

QUESTIONS TO ASK THE DOCTOR



  • How do I take care of my trachesotomy?
  • How many of your patients use noninvasive ventilation?
  • Am I a candidate for noninvasive ventilation?

User Contributions:

Carmen
Report this comment as inappropriate
Dec 30, 2007 @ 7:19 pm
My dad has had a trach in since November. He had it taken out last month and he is having issues right now. What do you think?

Carmen
Julio Macias Sandoval
Report this comment as inappropriate
Nov 24, 2008 @ 12:00 am
Emergency tracheotomy could be performed by any instructed person when its necessary.
Kari DeMilto
Report this comment as inappropriate
Apr 4, 2009 @ 9:21 pm
My mom who is 76 years old is currently in the hospital with initial dx of respitory failure. She is on a vent and they have been thus far unable to ween her off. It will be 2 weeks on April 6. They are talking about doing a trech. Would this be advisable?
Denise Sivalia
Report this comment as inappropriate
Apr 8, 2009 @ 10:10 am
my father will be turning 57 in july he's been in the hospital since march 24th... he went in for a biopsy on his right lung wanting to make sure it wasn't cancer now they can't get him off the ventaltor and they want to put a trach in does anyone have any advise they can offer.. if so thanks very much
Hannah
Report this comment as inappropriate
Apr 14, 2009 @ 1:13 pm
My sister is handicapped (she's had Spina Bifida since birth) and recently had a trach put in. She was in the hospital for three months total, and my parents took her in because she was having trouble breathing. Before the trach, she was put on a ventilator for two weeks, which was the worst time of my life. Since the trach, she regained her strength and now we can even put a piece on the trach so she can talk. It's saved her life, and if needed, they're very beneficial.
Mary
Report this comment as inappropriate
May 19, 2009 @ 5:17 pm
Hello
My dad is 93 yrs old and has been on a ventilator for over a week.
It had a colasped lung, pneumonia, and the sack around the lung had two different infections. They have a tube in his chest to drain the infection. Now they want to put him on a trech. He is normally in good health and very active. What are his chances of just being on the trech temporally?
Paramedic
Report this comment as inappropriate
Aug 5, 2009 @ 1:13 pm
Paramedics are also trained to perform this procedure. It is relevant to the fact that we get many choking patients and traumatic patients that need to have an emergency tracheostomy.
Rolanda
Report this comment as inappropriate
Aug 12, 2009 @ 1:13 pm
My Father is 66 he has been in the hospital since july 9th had open heart surgery then ended up with pneumonmia and trouble swallowing(Dysphagia) and then ended up with a yeast inection in his blood from a picc line now we are back to square one again now they want to do a tracheotomy temporarilly is thisd advisable
Jesse
Report this comment as inappropriate
Aug 16, 2009 @ 8:20 pm
Hi, my name is Jesse and I am a wheelchair bound twenty four year old male. My disability is rare(Arthrogryposis)which means the muscles within my legs did not grow. I have been to the E.R. about 5 times this month and everytime was discharged with being diagnosed with Dysphagia and Dyspepsia. They told me I was in need of a Tracheotomy and/or Gastro intestinal Probing.

My complaints were; trouble breathing, acid reflux, belly pains, mucus and other secretions entering windpipe, windpipe 1/2 blocked off, Insomnia, not able to feed, constant throwing up, not being able to go #1 and #2 without pain, painful to talk, painful to breath/swallow, painful to concentrate on people talking to me directly, and last but not least a constant cough while spitting up black saliva from time to time with the cough.

I have lymph nodes in my neck that are enlarged and feels like huge soft pebbles in which you may move them around the asophogus freely within the neck. At first they said they were thyroids but when I continued to go back in the E.R. they mentioned that the thyroids were not swollen. They can not find out exactly wat is wrong with me in the E.R. I personally believe I have a tumor in my neck but will not find out until tomorrow when administered the Gastro Intestinal Camera.

I have infections in my belly that cause acid to shoot up in my throat. The anti-biotics they prescribed to me are, 20 PANTOPRAZOLE ER 40MG (Generic for fluid Protonix) which was injected in me by an I.V. Another one was PRILOSEC 20MG. They also prescribed me PROAIR HFA (Albuterol Sulfate) Inhalation Aerosol for Oral Inhalation.

I am looking for someone that has similar problems that may contact me with information about these symptoms and might be able to give me a little heads up. More than anything, I am scared and frightened that my life is in jeopardy. My family are not supportive and do not care. If their is a person out there that I may relate to, please contact me via email. IMike27I@hotmail.com
Rita
Report this comment as inappropriate
Jan 10, 2010 @ 5:17 pm
My Husband Larry has a Trach for 5 years due to Laryngeal cancer, he still has his voicebox, however he has nothing but problems breathing since he has the Trach. We have been unsuccessful in finding a specialist in NY who can help him. His oxygen and lungs are fine, but still has difficulty breathing. No Doctors here seem to have the knowledge needed for the problems with the Trach.
willie
Report this comment as inappropriate
Jan 29, 2010 @ 9:21 pm
my son was born with a narrow jaw and a cleft palette so he could not take the botle. A mandibular distraction was don to correct the problem. In the OR the doctor came out after the procedure and said everything went fine but he wanted to do a tracyotomy because he was afraid when he pulled out the breathing tube his air way would colapse we said no but finally consented after being told it would be temporary so he could could check for airway blockage but now that there are no blockages he will not remove the trace tube because he said they child has an unsafe airway in his opinion eventhough the child had no breathing problems before the surgery. We are angry and frustrated because the doctor told us if we want it removed we have to remove it ourself - what do we do at this point?
Report this comment as inappropriate
Jul 6, 2010 @ 8:20 pm
Ive had a trach for 7years and i am 52was 45 at the time .IT has saved my life and im still doing fine with it still in place.SO I THINK I KNOW HE WOULD BE HAPPYER
Mohit
Report this comment as inappropriate
Jul 16, 2010 @ 6:06 am
I want your advice my friend mother done trache she got a paralysis attack and now lot of cough comes out of tube and she do cough so is there is any severe problem by this and she still uncouncious? And how much time these patients takes time to get recover?
Report this comment as inappropriate
Jul 18, 2010 @ 9:09 am
If a patient is on mechanical vent and cannot be weened off, how do the dr.s perform tracheotomy to place trach tubes in trachea?if patient cant be off vent, how can they breathe until trach tube is in place
Report this comment as inappropriate
Oct 23, 2010 @ 8:08 am
Iam a Veteran,70 yrs, ALS patient, my oxygen level has decreased,my Dr recommends a tracheotomy. WOULD this be advisable?
Report this comment as inappropriate
Dec 4, 2010 @ 7:19 pm
Hello,
My husband had a trach done after a motorcycle accident . It was in place to help him breaath with a vent. he was taken off the vent and the trach was taken out after about a month. This has been 2 years ago. He is having problem every now and then where he seems to not be able to get any air in or out. This sometimes happens at night. Very scary it has also happened while he has been eating. It take several seconds which seems like minutes to get air moving again. I was just wondering if there could be scar tissue there from the trach that could cause this problem.
Report this comment as inappropriate
Dec 17, 2010 @ 10:22 pm
Wy cant the doctor close my trach? I am brathing prfictly fine now and other than my trach im a healthy 24 yearold female. Everytime i go into surgery to close it, the surgen tells me they cant cause it keeps clapsing what do they mean by that and what cause it to claps. what can i do to help the healing process or is this gona be prminint
Jim Kelly
Report this comment as inappropriate
Dec 28, 2010 @ 6:18 pm
A tracheotomy seems like an obvious solution to the problem of obstructive sleep apnea. Why is it seldom considered and not even discussed with patients as a potential solution? A temporary tracheotomy would, if it gave the patient relief from apnea symptoms, give justification for alternative long term treatments.
Report this comment as inappropriate
Jan 13, 2011 @ 9:21 pm
Dad
here is the info on the procedure that will be done
shelley
Report this comment as inappropriate
Jan 25, 2011 @ 6:18 pm
I have a friend whose husband has a trache and he suddenly is doing alot of hickupping. She cant get him to stop and dosent know if its harmful for him to be doing that. She wants to know if theres something wrong or something she cando for her husband. Hes not able to speak or communicate at this time. She takes care of him at home and has tried to call the doctor but cant seem to get any answers.
Report this comment as inappropriate
Feb 5, 2011 @ 3:15 pm
my wife had trech after surgery now has constant cough is this common
Report this comment as inappropriate
Mar 10, 2011 @ 12:00 am
What is a ventilated inner cannula and how long should it be u8sed before switching to a regular inner cannula? Is one better than the other ? How long should I use the vented inner cannuls and what are the side effects, if any, of either type of cannula
Bonnie
Report this comment as inappropriate
Mar 12, 2011 @ 1:13 pm
How often should a trach face-plate be changed? I heard six months from some doctors and a year if there are no infections present. What do you advise?
Report this comment as inappropriate
Mar 15, 2011 @ 11:11 am
Can you provide statistics for the overall mortality rate for all discharged tracheostomy patients between 1930 an present? Or if not for that span of years a reasonable average estimate. I have the statistics for the number of tracheostomy patients discharged from all US hospitals since 1930, and am trying to determine the total population of tracheostomy patients, preferably permanent trach tube patients.
Report this comment as inappropriate
Apr 25, 2011 @ 10:10 am
I am Tammie and I am having a vtrach done to hewlp with sleep apnea is it really a good idea since I stop breathing at night?
Report this comment as inappropriate
Jul 21, 2011 @ 4:04 am
I came home from the hospital May 11, 2005 after a 19month stay. I had complications from an open rny. The trach itself was taken out before I came home. I was told it would heal on it's own but today I still have a hole. People ask me why I don't have it closed. I give them the it's to much money to have it done. But the truth is I am very scared. What if I wake up and can't beathe. I am very very afraid. Can you explain to me step by step the procedure. It's been way to long and it just needs to be closed
Report this comment as inappropriate
Aug 15, 2011 @ 9:09 am
Hey, I'm a medical student. This article is really good. It answers all my questions on this topic.. Thank you!
Report this comment as inappropriate
Aug 30, 2011 @ 5:17 pm
my moms had an emergency tracky this morning,shes doing well considering...im concerned about after care.
Report this comment as inappropriate
Sep 9, 2011 @ 9:21 pm
My uncle is in the hospital after a fall from a latter and huge hit to the head. He is in critital condition and doctors are wanting to do a tracheostomy and want to know what it is for? Will this be of any help to him?
Farzana
Report this comment as inappropriate
Sep 12, 2011 @ 2:14 pm
My mum had a tracheostomy done because she was on the ventilator too long, the day after she was smiling and was very happy, but unfortunately, after that, it became infected (bacterial) and she ended up with septecemia because it got into her blood stream. Please pray that God grants her complete recovery. Ameen. Word of advice though, no matter whether it's the best hospital in the world, make sure that the nurses are properly trained. I don't know how it got infected, but precautions have to be duly noted. Also, try not to breathe on the patient (rather wear a mask) so that you prevent any unknown germs from yourself. I was pretty confident when I read about the tracheostomy procedure etc, little did I know it could lead to this.
Cornne Douglas
Report this comment as inappropriate
Sep 29, 2011 @ 11:11 am
Is it possible for a trach to rub on an artery to cause hemorrhage, and what artery would that be? I am an RN and never heard of such until just recently a friend just had this happen to her friend's son in the hospital.
Report this comment as inappropriate
Oct 7, 2011 @ 11:11 am
I need to know the name of the apparatus used to assist someone with a trach to talk. Where doyou purchase this item? Thank you.
Report this comment as inappropriate
Oct 14, 2011 @ 7:19 pm
I have a pt who obviously had a tracheotomy but has no tracheostomy apparatus, just a hole in his neck that, upon coughing, covers with a tissue to catch any residual. He has full utilization of his voice box but can only string about 3-15 words together before he is out of breath. Q=Is this "hole" still referred to as a tracheostomy? Thank you to anyone who can assist me in the next 5-15 minutes! ~sarah
Report this comment as inappropriate
Oct 24, 2011 @ 10:10 am
I recently had a cut in my throat to do a bi-opsy of several lymph nodes. Everything healed ok, but now 13 days later, I have a large lump where the incision was made. any problems associated with this?
Report this comment as inappropriate
Nov 1, 2011 @ 9:21 pm
Hi my name is dusty I am recovering from a recent car accident I had no injuries above my pelvic bone but I am now trached. The doctors had me on a ventilator for about two weeks and they trached me so I could be taken off. Its about two months after my accident and my doctors are telling me that it ccan be fixed but then their saying it can't I am wandering if anyone knows of a very good specialist in the pa area I can contact. You can contact me at dusty21619@yahoo.com
Report this comment as inappropriate
Nov 3, 2011 @ 12:12 pm
Hi My name is Namita, my mum has a problem in left lung and she developed cough during this winter season. Doctor susggested to do trachestomy and kept her on ventilator a week ago. now she is remoived from ventilator but doctor giving her lil bit oxygen. She is also screting mucus and cough. still in hospital. i hope she will be fine as early as possible. she is scared from the surgery done and i could not see her in pain. she used to cough. I hope it gets dried up soon.
i am very much worried but hav hope and trust in GOD.
Normally for a patient like her, how many days takes to recover completely.
she is 53 years of age.
priscilla
Report this comment as inappropriate
Nov 15, 2011 @ 1:13 pm
My son had a trach that healed over perfectly. It looked good and smooth and hardley noticeable, and now 3 months later has a big lump on the side of it and looks horrible and even scarey. What could have happened. It looks nothing like what it did when it first healed. Help please. Priss
Report this comment as inappropriate
Nov 24, 2011 @ 6:18 pm
my daughter have trach for 4 months now.how do we know if its time to remove it.she is a vehicular accident patient.her lungs is normal now.pls help
vicky
Report this comment as inappropriate
Dec 20, 2011 @ 8:08 am
hi my name is vicky, wat are the equipments that needed for this procedure?
Mary
Report this comment as inappropriate
Dec 28, 2011 @ 9:21 pm
father inlaw was hit by a car 3 weeks ago he was on ventalation for the first week and thee drs said they needed to do a trach we let them do it but every time they try to ttake him off there are complications lungs keep filling up faster than they suck it out we get the run sround from the trauma team they keep.telling us it will be a couple of days till he csn talk this has been told to us for 3 weeks now does anyone have any in put
tony
Report this comment as inappropriate
Jan 10, 2012 @ 1:01 am
My mom has stage 4 lung cancer. She has been with this fight for over 2 years. They want to put a trach in bc she cant breath on her own power. What is the lifespan when a stage 4 luncer has a trach in..Some one please help.
Kia
Report this comment as inappropriate
Feb 19, 2012 @ 1:13 pm
My mother had an brain aneurism in 07. Which caused her to be hospitalized for 3months and have a trache it stayed in for a few weeks after coming home and after the scare healed it was and still is back to normal life for her. Thanks to Gods blessings and the staff at jefferson hospital in philly...
Michelle
Report this comment as inappropriate
Feb 26, 2012 @ 9:21 pm
My Mother was swelling up and having respitory distress, so she was admitted to the hospital on Valentine's Day. That evening she coded and was put in the ICU. She is currently sedated and on a respirator and has had several rounds of dialysis. Her swelling has gone down considerably, and she has been going thru breathing trials to see how well she does off the vent. She has some good trials and some bad ones... There has been talk of performing a trach to help her recover... and talk of doing to relieve her sleep apnea. This scares me to death!! I don't know her wishes on this, but I know she doesn't want to be on a vent if there is no way of coming off. As she can't make this decision, it falls on me. Any advice?
LINDAA,
Report this comment as inappropriate
Feb 27, 2012 @ 4:04 am
I would like to know how hard itwould br to remove s resce from your throat?
Report this comment as inappropriate
Mar 8, 2012 @ 6:06 am
my name is kaye i have been trached since 2006 and have had my ups and downs on it.i use a flow by during the day and on a home vent at night.i am a very large woman just to let you know a little about me.three days ago i went from a 97%on my oximeter to a 42% in less then 15 minutes.i had to get on my vent in order to breath i have never had this happen before.everytime i put on my oxygen hose so i can go to the rest room for 5 minutes i drop into the 70's and can't hardly breath.but even on the vent i feel it's a little bit of a struggle to breath.i would go to the hospital but have no one to take me and if i call an ambulance all they have is oxygen and i fear i would die before i get to the hospital i have gained a little weight but am afraid to even eat now cause in fear it might be why i am having so much troubles.but,what if i'm wrong and something is truely wrong i can't go without the vent without passing out and dieing and the vent has to be hooked up to electricity.i'm very scared any ideas on what to do or maybe what i need to do to breath better?please help
Hailey
Report this comment as inappropriate
Mar 18, 2012 @ 12:00 am
Tomorrow morning at nine my boyfriend is going to have one put in. He was in a bad car accident a week ago and he is in a coma he is slowly starting to wake up and when he does we all feel he is going to try and pull that ventilator tube out of his mouth so we think that this will be more comfortable for him to deal with when he wakes up. He also has to have two other surgeries at the same time. Our family needs all the prayers we can get for him so please Pray. He just turned 22 on Wednesday. He is so amazing so strong he is coming back to us but it's goin to be a long road ahead. Thank you this website answered my questions.
Katy
Report this comment as inappropriate
Mar 18, 2012 @ 11:11 am
My Dad (69) had a trach in for about 30 days while in intensive care as he had developed pneumonia. He did have damage to the vocal cords but they appear pretty much recovered. However, two months later he is still coughing and says it feels like something is stuck in his throat; he puts his hand to the trach scar. I have tried Google and at the risk of a little knowledge being a dangerous thing, is it possible a 'granuloma'could be causing this? Has anyone else expeirenced a similar problem post recovery? Did it just naturally resolve itself? Thanks. PS If you have a loved one about to have a trach because they are critically ill - don't lose hope medical staff are amazing and people can be nursed back to health from the most difficult circumstances; my thoughts and prayers are with you.
kendra
Report this comment as inappropriate
Mar 21, 2012 @ 5:05 am
My boyfriend found out he had throat cancer about 3 years ago.after radiation and chemo therapy he began having breathing problems and would have to sleep upright.eventually one night he had to be rushed to the E.R. because his oxygen level was down.they performed a tracheotomy and ever since then there's been quite a few ups and downs but for the most part it saved his life.he has gained back his weight,is cancer-free and resumes his life somewhat the way he once did. however he constantly coughs up mucus and at times it bleeds if the room is not well ventilated.The docs say there is still alot of swelling in the neck area and if and when it goes down,they may be able to remove the trach.Does anyone know just how long this kind of swelling lasts and why some people can heal easily after the removal while others end up getting it put back in?
Lynette
Report this comment as inappropriate
Apr 27, 2012 @ 7:19 pm
My grandmother has been in the hospital now for 30 days. She only went into the hospital for an ulcer leg. However, she became very ill and stopped breathing. She was immediately placed on a breathing machine. The doctor's informed us that her left foot had to be amputated below the knee. She was fine and everything worked out well. She was then weaned off the machine days later and was talking to us. She had a bad cough though. Then, after a while, she was taken out of ICU and placed into a ward. This time, her heart stopped beating and she was then placed back on the machine. However, days later the doctors informed us that she was need a tracheostomy performed. She recently had the procedure done and is now in the ICU ward of the hospital. The nurses and doctors have admitted to us that she is a very strong 65 year old woman. They are letting us know that sometimes the body does become adjusted to antibiotics and they want to be as honest as possible. I have said all of that to say "There is nothing and I mean absolutely nothing to hard for God!" I am believing him to heal her like he did before and bring her out of the hospital as a mighty testimony! I am also believing God to heal each and every person who has made a request on this website for themselves or a family member. Know that you or your family member is healed in the name of Jesus! Hallelujah! Amen: So let it be!
Linda
Report this comment as inappropriate
May 5, 2012 @ 11:11 am
My Dad,is on a breathing machine, has difficulty swallowing they want to do a trache. Not sure if he will need it forever, they say probably! But he was breathing just fine when he went in to the hospital, they made it worse. Please pray for him
kim
Report this comment as inappropriate
May 25, 2012 @ 2:02 am
my son was born at 30 weeks his lungs where not developed now he is off his vent still has his trach but wears his cap all day but seems to make a lot of noise when he wears his cap when sleep his stats stay fine its just the noise he makes is it normal tthey r try to get him ready to take his trach out if any one out their has been threw this step i love to hear ur opions cause i just dont know no more
Barbara
Report this comment as inappropriate
Jun 7, 2012 @ 6:06 am
i have a trachie in since 2002 due to genic vocal cords paralysis and am having so much trouble this last lot of months ive so much pain in the site and it so painful and uncomfortable i got the camera put down but nothing found i cant understand what it is and have constant infections in it and was talking antibiotics but wasnt rally helping i also have a condition called dynactin mutation which is under investigation can any help me please
Report this comment as inappropriate
Jul 18, 2012 @ 4:16 pm
I had a tracheotomy 55 yrs ago and have scar tissue from it. At times I have a hard time breathing. Could it be from the tracheotomy? Also if I drink or eat anything cold I start coughing.
Report this comment as inappropriate
Jul 23, 2012 @ 7:19 pm
On December 31, 2004, at the age of 19, I was involves in a severe car accident. Being pronounced 'dead' at the scene, the paramedics had to cut my throat in order to remove my 4 front teeth from my wind pipe. They put in a trach tube after arriving to the hospital, and performed a tracheotomy to reteach my respiratory system to breathe on its own again. It was taken out as I woke from my coma 21 days later. In waking up, I didnt know what had happened, and tried to yank out the tube myself. Since then, my body has continued to repair utsself, and thank GOD, I am in school now to learn more about my both previous and present condition. I attend Southern Yechnical College in Auburndale, Florida, and am studying to get my MA degree. In graduating, I will proceed to open up my own Rehab Facility to help others with similar conditions.
Report this comment as inappropriate
Aug 4, 2012 @ 11:23 pm
My father is 74 years old and he was operated Tracheotomy in throat for cancer 2 YEARS before
Now My brother taking care of daily cleaning , Now my father wants to close the hole is there any chance to do that
jenjen
Report this comment as inappropriate
Aug 19, 2012 @ 3:03 am
what to do if the phlegm is still dry even almost all intervention done to lass the phlegm. the meds for it, nebulizer and back tapping? nss is allow to inject it to her tracheotomy tube to loss the phlegm?
Duwayne Hepburn
Report this comment as inappropriate
Oct 11, 2012 @ 3:15 pm
My father had extensive kimo on his throat for throat cancer approx 12 years ago. It has caused his breathing to be difficult. He does not want to have a tracheotomy please give me alternative procedures he can have done.
norma
Report this comment as inappropriate
Jan 13, 2013 @ 3:15 pm
I had a tracheotomy done in Aug. and it has healed up, but sometimes when i eat i feel like some food gets stuck in my throat and i try to drink alot to make go on down sometimes it works and sometimes it don't, any thing i can do?
Report this comment as inappropriate
Jan 26, 2013 @ 6:06 am
my wife will be on the venelator for two weeks in 3 days. Doctor has told me about the Tracheotomy being the next step. She at first agreed to use venelator for help if it could help her and she did not want any permanent life support. She changed her mind the next day and progressively her condition got worst. She agreed the following morning to let them use the venelator to help her through her condition. She had lung surgery in Nov. 2012, previously had lung surgery Nov. 2009. Both times were to remove upper left lobe of her right and left lung. She has had problems with her digestion system since the previous Nov. lung surgery and was diagonised with delayed gastric empting and had to have a JPEG tube insertered for nurtrition for her body. While were were a couple days recovering from this she developed blood clots and pneumonia in her lungs and we are where we are now with venelator and praying the lungs and scar tissue from pneumonia will improve to prevent the Tracheotomy that will be next step. i am lost and know that she has a living will that states no permanent life support. from reading all questions and the possibility of scar tissue healing in time i find that this procedure is not permanent as you may first think. Is it reversible and could she be able to talk normally again if the Trach is removed it the future. i need to know some answers to these questions and any other helpful information i can get so that i can share it with her to help us make a good deceision about her health and care before we make a deciesion that we both will regret. The Lord is working his miracle through the doctors but is this the time that we need more time for healing than the lungs will allow and we need this additional help to heal her. Please help us.
Report this comment as inappropriate
Feb 6, 2013 @ 9:21 pm
I was diagnosed w/ ALS last 8/24/12 . I can no longer talk & my legs are weak,have difficulty swallowing etc. I am using a ventilator ( 3-4 hrs / day) & once in a while a cough assist machine. I can breath ok but maybe due to my illness I felt weak and out of breath sometimes. When I am inside the car I have to open the window to have some air or else I felt suffocated. I went to see a pulmunary doctor & he mentioned about this tracheotomy which I do not agree. I can still breath & sleep well I just have to position my head little bit upward & I use 2 pillows & I am alright. Also my neurologist recommends me to have a feeding tube. I can still eat but a struggle. I do not know what to do.I am 66 yrs. old this April 15. If possible I do not want to do any of these. ANy comment ? Thank you..
Alyn
Report this comment as inappropriate
Feb 11, 2013 @ 12:12 pm
My husband have a copd and he contracted a staph pneumonia he was put in a ventelitor for 6 days.After a week of removing the ventilitor they put it back again cause he was having hard time breathing and and his vitals goes up The doctor told me this morning of the possibity of putting a trach on him. My question is,if person has trach can they still speak?
eli
Report this comment as inappropriate
Feb 17, 2013 @ 11:11 am
exellent its veri good and use full i injoy it.jjkkl nklfrtu kjjhgft lot kjh kjiu kkji ourell llwa lppib
barri
Report this comment as inappropriate
Feb 22, 2013 @ 5:17 pm
My mom has a trach for about a week and a half now. She was given blood on Tuesday, of this week and now needs another pint. Is this common to required blood so often after a trach? thanks,
Elizet
Report this comment as inappropriate
Feb 24, 2013 @ 9:21 pm
I had a trach because I couldn't breathe through my nose. But It's been about a month and a half and I still can't breathe through my nose my doctor says he's probably going to have to do an infiltrated something. Does anybody know what that is and what it's like
Kris
Report this comment as inappropriate
Mar 4, 2013 @ 9:21 pm
My mom 86 had heart surgery it is 10 days later they want to do a trake tube and a feeding tube..this is so confusing
whya tube so soon?
renee
Report this comment as inappropriate
Mar 15, 2013 @ 9:21 pm
mom is on ventalator and dr is recominding a trach, is there any quality of life with a trach? such as personally taking care of self?
Katie
Report this comment as inappropriate
Mar 22, 2013 @ 11:23 pm
My sister had a bad car accident in which she broke her neck a couple of years ago. She had been on a respirator for a little while and then the doctor desided to put in a temporary trach so that she would not become dependant on the respirator. She no longer has the trach but, now she is having trouble with her oxygen levels dropping to 60% and sometimes a little lower. She is parallyzed from the waist down. Could this possibly be caused by scar tissue build up after her trach was repaired? She is now going on oxygen 24/7
Dina
Report this comment as inappropriate
Apr 11, 2013 @ 6:18 pm
My 49 years old cousin had two heart attacks recently and she had been put on a respiratory. She is comatose and the physician decides to perform a tracheotomy before transferring her to a nursing care facility. The family wants to see if there will be any improvement after two to three weeks otherwise the plan is to let her go naturally. The question is: would the nursing care facility agree to remove the trach?
wendy
Report this comment as inappropriate
Apr 24, 2013 @ 5:05 am
My father has been in ICU with a collapsed left lung, been tubulate for this length of time they can't do a trachea due to scar tissue from previous tracheas done, any suggestions to help get him off this machine. he fights the tube every time the wake him up and his mouth is full of sores and bleeding, he only weighs about 38 kg's now.

Wendy
tasha
Report this comment as inappropriate
May 4, 2013 @ 10:10 am
my mom just had a trach put in her a few days ago and they said soon she will be able to go home but my question can one person be in the house with obese with chronic illness while the other has a trach?
Linda
Report this comment as inappropriate
May 20, 2013 @ 11:23 pm
I've had a trach for 15 years. I've had infections around the tube a few times, but they've always cleared up with antibiotics. However, the CDC told my Dr. not to treat it unless absolutely necessary so the only time he treats it is when I have pain. This has happened only once in the last few years. This is my second trach. I had one in 1961 when I was 20 years old and had some shortness of breath without it, but was able to live normally until 1997. Because of the first trach scar tissue the tracheotomy in 1997 had to be done above the first one and doesn't sit flush to my throat so it leaks and drains a lot. I use a 2X2 I.V. sponge to keep the drainage contained. I have to suction frequently; especially when I eat or drink anything. My trach is a metal Jackson trach which I prefer. I tried the polymer or plastic kind for a month at first and didn't like it so my surgeon allowed me to keep the metal Jackson. I have to clean my inner cannula so often that I don't always use a detergent. I have several sets of inner and outer cannulas and introducers. I take the whole tube out every 4 to 6 weeks and replace it with one I've cleaned and decontaminated by washing then boiling it for 15-20 minutes and use sterile technique when inserting it into the stoma. I haven't had pneumonia or any kind of lung infection until a few weeks ago. I had aspiration pneumonia and was quite sick. I've recovered and doing well again. The doctors who treated me were not my surgeon and didn't know me well. They all said I'm in remarkably good health and so are my trach and lungs. Why? No one knows for sure, but an educated guess is good trach care and I take good care of myself in general. They were also surprised that this is the first time I've had pneumonia. I've been concerned about longevity/life-span with a trach and was glad to find this site because it states that studies show long term trachs don't shorten life span. I'll be reading this site more often now just to see if anything new comes up.
Report this comment as inappropriate
Jun 2, 2013 @ 3:03 am
I had breathing problems when i was a kid im now 19 and i had a trachea put in when i was 2yrs old and i had it removed when i was probobly 4yrs old and havent had problems since mucus tends to leak from it when its spring time and every now and then it will squeek when i talk now when i go swimming and when i come up from the water i start coughing because the water will enter my treache and end up in my lungs and thats one reason i will not go to the deep end of the pool ive had about 50 or more surgeries on my jaw because i was born without the left part of it i refuse to have more surgeries im wondering if theres medication or somthing that will close the trachea up WITHOUT HAVING SURGERIES.
janice burris
Report this comment as inappropriate
Jul 4, 2013 @ 8:20 pm
Hi, my brother has stage 4 lymph cancer and has battled it now for 3 years with radiation etc. Recently, 3 months ago he had a tracheotomy done. He was having problems getting air into his lungs from fluid filling up possibly from a side effect of radiation. Well, despite all that my brother had a healthy 3 square meals a day appetite. But since the trache he has failed 3 swallow studies. Since the trache he can't cough and 10 percent of his food now goes to his lungs, as where, before this never happened. My brother doesn't have much of a quality of life. He only wants to taste food again. How is it 99 percent other people with traches and treatments can but he can't. Who can help us? Now he is hospitalized again with an infection in his stomach for the entire time supposably he got the gtube during the trache which has been about 3 months now, and cannot even have the jevity milk, instead he is on an IV line for a week, hoping his old gtube area will heal. He has a new gtube area to begin his new feedings. But this is not what he wants for God sakes he just wants to have some quality of life and taste food. There is one other possibility that a nerve in his throat either got severed during surgery or is not responding to tell him to cough. Either way it goes, any advise any one can give us would be great.
Rubi
Report this comment as inappropriate
Sep 12, 2013 @ 12:00 am
I've had an emergency tracheotomy since I was 5 and 1/2 months due to phlegm buildup. My parents were told I'd grow up w/complications, probably not able to speak again. Today, I speak in 2 languages & sing w/my tracheotomy. I am almost 47 yrs of age w/out any complications since that horific day. I honestly don't remember it but the scar on my neck "marks the spot" where the incision was made. Close to 9yrs ago, I was diagnosed w/cancer. It was also found in the lymphnodes, getting ready to protrude to the nxt part of my body. But this case was confirmd, "not related" to the tracheotomy surgery. I underwent extensive chemo, radiation, herceptin (preventative medicine) and pill-form tomoxafin. While on chemo, I did encounter issues w/swollowing foods. I kept feeling small-like particals stuck in my throat. I also experienced the swollen glands but did not consider the thought of a tracheotomy complication. I thought it was all due to the chemo treatments. But now as it's been close to 10 yrs healed from cancer, I do get excessive phlegm & coughing up tiny food particles, once in a while. Should I have the tracheotomy checked out? There is no pain in the area, just sometimes, it feels as if I can't swallow my food all the way down. Also, I tend to chokeup on water on rare occasions. Plz advise.
Santosh
Report this comment as inappropriate
Nov 7, 2013 @ 3:03 am
My dad who is 79 years old is currently in hospital struggling ILD. He is on ventilator since past 4 days, however the weaning process does not seem to work. His O2 level goes down with increased breathing, when ventilator is reduced. His BP also drops and is fluctuating. His X rays shows more than 2/3rd of the lung damaged. He has also tested positive for TB. It does seem like fighting a loosing battle, however is it advisable to go for tracheotomy? I know this will prolong his pain and suffering, but usually what are the chances of survival after taking such patients off the ventilator?
nurse
Report this comment as inappropriate
Dec 29, 2013 @ 12:12 pm
Why are so many people asking questions on here when no one is answering? That seems silly to me. Several of you people need to speak with your doctor or get the advice of a different doctor if yours isn't explaining anything to you. Patients who are on a ventilator and not able to get weaned off-a trach will not help-that is his lungs. The tracheotomy only helps in the situation where there is a "blockage" or "obstruction" in the mouth to throat, such as food is obstructing or a tumors/cancer, or severe anaphylaxis (where you have an allergy and your throat swells shut) or inflammatory response similar where the airway is too narrow for air to flow through. By making a hole--it bypasses the throat and mouth so air can be sucked in through this hole into the lungs. The problem is that normally the nose and mouth are able to filter out bacteria and contaminants better than this "hole." So people with trachs are at a higher risk of getting infections and pneumonia (infections in their lungs). Scar tissue can develop YES- which can make closing the trach harder- because now you will have a stiff scar tissue buildup on the other side of the windpipe. Also it can potentially collapse on itself- but I am sure a good ear,nose, throat surgeon has some sort of cartilage replacement material that they could use to help hold open the windpipe(trachea) just like theres fake silicone in boobs lol, there are fake materials for bone or cartilage that surgeons use. 73-he needs to get a barium swallow study done from a speech therapist. he needs to be sitting completely upright when eating and must eat thickened foods it sounds like or he will aspirate (goes down his lung- that's why he got pneumonia)-consider the QUALITY of these peoples lives. If he wants to taste food bad enough- put him on hospice- and let him eat whatever he wants-steak who cares-he wil get pneumonia but will be happy until he dies naturally- if that's what he wants then give it to him- if he wants to live longer than he needs to give up food until they figure this out and be fed through a tube in his stomach..72- SIT UPRIGHT 90 degrees when drinking thin liquids such as water or thicken them up with a powder you can buy called thick-it. 70-HOME HEALTH should be assigned to her upon discharge- a nurse should be able to visit her and clean it while shes at home. They may send CNAs as well. THis is called the discharge planner who orders these while in a hospital.
75- no if he comes off the vent he will die. survival chance is 0% 69- As his lung heals (He may have a chest tube if its badly collaped- They will slowly wean him off until he can become off the vent. There is no other way- him fighting it is good- he needs to be semi-conscious to be able to breathe on his own although its hard to watch. 68- The nurses WILL NEVER remove the trach unless a doctor orders it.
Again people this isn't medical advice- and you need to talk to your doctors more- and even your nurses. ALso this procedure is VERY RISKY don't ever do this really because you could hit the arteries and kill the poor person. Try the Heimlich EFFECTIVELY and then CPR and sometimes CPR makes the food come out. (chest compressions can push it out).
Goop
Report this comment as inappropriate
Jun 9, 2014 @ 8:20 pm
My husband has had a trache since January 2013, due to intibation.

He was told that a device could be inserted to help his vocal cords open and close properly.

Is this a safe procedure? He is in the mid 70's and uses his voice a lot in speaking. We were told a couple months ago, that there were two polyps that needed to be removed and that the trache would be in permanantly. We were so disappointed because we had been told that a year from when he had stints inserted in his heart that this device could be inserted.

Help!!! He is so tired of the trache, but we're blessed that he is still alive.

Please comment
graciela
Report this comment as inappropriate
Jul 17, 2014 @ 2:14 pm
Is there any recommendation on how my dad can communicate with us? He is 77, had a tracheotomy 2 weeks ago and he is not able to move his hands bc is too weak.
I wonder if there is any suggestions for us to communicate with him.
He is trying to talk to us but we can't understand. He is able to close his eyes so I'm only able to ask him questions where he can answer for Yes or No.

We live in South America. Any suggestion will help!! Thank u and I'm sorry for my grammar / spelling.
bobb
Report this comment as inappropriate
Jul 25, 2014 @ 11:11 am
hello...i just found out my mom is getting a tracheotomy---she has copd---and is unable to exchange co2 very well.

i want to know if it is possible for her to do her home ventilation care at home---instead of at a nursing home.

i admit i dont really know much about this subject--but greatly appreciate any info...
Kalene
Report this comment as inappropriate
Aug 11, 2014 @ 12:12 pm
I was recently in the hospital for anaphylactic shock. They couldn't find what caused it. I was on a ventilator for two weeks and then on a tracheostomy for another two weeks. It's been about two and a half months since I've been home with no dx. Since I have been home from the hospital I ha ve had a hard time breathing when I'm lying down with my head turned to the left side, flat on my back, or reclined. It's like there is a flap that closes over my breathing tube. I have consulted several specialists with no answer. Can you help?
Dusty
Report this comment as inappropriate
Aug 13, 2014 @ 10:22 pm
Hi my name is dusty 3 years ago I was in a car accident. I went into shock and had to be ventilated they had me in a medically induced coma for about two weeks. They tried several times to remove the tube but my throat kept swelling they then put in a tracheostomy tube . It was suppose to be temporary I had it for a few months and I was able to be capped so they decided to remove it. about two weeks later I had to be taken in and have an emergency surgery to have it put back in. The doctors thought my scar tissue was lower in my throat then what it was so they put in a extra long tube I had to have it replaced with a size six because my scar tissue is up behind and below my vocal cords. Now my doctors say it is permanent . I'm very thankful to be alive but I am only 22 years old. I very much and open for suggestions on doctors maybe at the Cleveland clinic in Ohio or anything else. I'm use to the tube by now but I would love to be able to get this fixed and mybe get back to work or anything that I did before.
Joshua
Report this comment as inappropriate
Aug 25, 2014 @ 12:00 am
My Daughter now 7years living with a tracheostomy the Doctors in Israel recommended that she should not be decanulated the usual way but the doctor here wants to denaculate the normal way should I accept this am concerned that it may result in more fatal scenario.I need advise.
Nora Martin
Report this comment as inappropriate
Sep 1, 2014 @ 4:16 pm
for a person coming off a ventilator having tracheotomy--since patient is have problems breathing without ventilator, after tracheotomy procedure how do they get oxygen?
Report this comment as inappropriate
Sep 3, 2014 @ 2:14 pm
I am wring this informtion because we don't know what to do for our dughter. She has a feeding tube in her stomach, but the hold where the tube is inseted in her stomach is tooo lage and the tub is sliding up to her throat and into her mouth and she is in pain all the time. All of what she eats or drink comes back up and it wastes out her stomach because the hole is too big. My question is to any doctor who has the answer on what do do, please contact me and provide a hospital that is willing to make the hole smaller and medication that will help her to stop throwing up. she has lost a lot of weight, because all her nutrients that she eats pours out of the stomach and she is constantly wiping herself off. Can you please help us?
lyly
Report this comment as inappropriate
Sep 11, 2014 @ 2:02 am
my brother is lying in hospital and he is breathing under oxygen for 4 days, he has lost a lot of weight, does not eat or move and he is HiV positive. when i called the hospital wanting to know about his condition, they say he does not respond to the treatment, and he is very critical just lying there, please help what can we do

Comment about this article, ask questions, or add new information about this topic:

CAPTCHA


Tracheotomy forum