What is a Tracheostomy?
A tracheostomy is an opening (made through an incision) through the neck into the windpipe (windpipe). Opening the trachea opens the airway and helps breathing.
A tracheostomy can be performed in an emergency setting, at the patient’s bedside or in an operating room. Anesthesia (pain relief medicine) may be used before the procedure. Depending on a person’s condition, a tracheostomy may be temporary or permanent.
When is a tracheostomy considered?
A tracheostomy may be performed in the following cases:
- Mouth or throat blockage
- Difficulty breathing due to edema (swelling), injury, or lung (lung) disease
- Airway reconstruction after tracheostomy or laryngeal surgery
- Protect the airway from secretions or food due to swallowing problems
- Airway protection after head and neck surgery
- Long-term need for ventilator (respiratory) support
What is a tracheostomy tube?
A tracheostomy tube is a small tube that is inserted into a tracheostomy to keep the opening (opening) clean.
Tracheostomy tubes are available in many sizes and materials including semi-flexible plastic, rigid plastic, or metal. The tubes are disposable or can be reused. They may have an internal cannula that can be disposable or reused. The endotracheal tube may or may not have a cuff. Tracheostomy tubes are generally used for patients who have difficulty swallowing or who are receiving mechanical ventilation. Unconstrained endotracheal tubes are used to maintain a patient’s airway when a ventilator is not needed. The choice of tube depends on your condition, the shape and size of your neck, and the purpose of the tracheostomy.
All tracheostomy tubes have an external cannula (main shaft) and neck plate (flange). The lip on your neck is located above the opening (opening). The perforations on either side of the neck plate allow you to insert the tracheostomy tube ties to secure the tracheostomy tube in place.
After going home with a tracheostomy, what do I need to know?
Immediately after your tracheostomy, you will communicate with others by writing so that your health care provider can give you instructions on communication techniques.
Do not remove the external cannula unless your healthcare provider tells you to do so.
Use tracheostomy caps to protect your airway from outside elements (such as dust, cold air, etc.) Ask your healthcare provider for more information about tracheostomy caps and where to buy them.
When should I contact my healthcare provider?
- If you have an irregular heart rate
- If you feel increasing pain or discomfort
If you have trouble breathing and this is not cleared up in the usual way to filter secretions.
When the secretions become thick, if crusting occurs or mucous plugs are present. Your doctor may recommend increasing fluids or using cold mist humidification.
How do I take care of a tracheostomy tube?
Your nurse will teach you the correct way to care for your tracheostomy tube before you go home. Routine tracheostomy care should be done in some measure once per day after you are released from the medical clinic.
- Stand or sit comfortably in front of the mirror (the bathroom above the sink is a good place to take care of the tracheostomy tube).
- Put on gloves.
- Endotracheal puncture tube suction. (Your health care provider will give you more information about the aspiration procedure.)
- If your tube has an internal cannula, remove it. (If the endotracheal puncture tube does not have an internal cannula, go to step 12.)
- Hold the inner cannula over the sink and pour the hydrogen peroxide over it. Use as much hydrogen peroxide as you need to thoroughly clean the inner cannula.
- Clean the internal cannula with pipe cleaners or a little brush.
- Rinse the indoor cannula well with plain saline, tap water, or distilled water (if you have a septic tank or well water).
- Thoroughly dry the inside and outside of the indoor cannula with a clean 4″ x 4″ mesh gauze pad.
- Reinsert the internal cannula and lock it in place.
- Remove the soiled gauze pad around your neck and throw it away.
- Check the skin around the stoma for redness, hardness, tenderness, drainage, or a foul odor. If you notice any of these conditions, contact your nurse or doctor after you have completed routine care.
- Soak a cotton swab in a solution of half hydrogen peroxide and half water.
- Dampen the cloth with plain saline, tap water, or distilled water. Use the cloth to wipe the hydrogen peroxide and clean the leather.
- Dry the exposed external cannula and the skin around the stoma with a clean towel.
- Change the tracheostomy tube ties.