A tracheostomy is a surgically made hole that goes through the front of your neck into your trachea, or windpipe. A breathing tube, called a trach tube, is placed through the hole and directly into your windpipe to help you breathe. A tracheostomy may be used to help people who need to be on ventilators for more than a couple of weeks or who have conditions that block the upper airways.
A surgeon can make a tracheostomy in a hospital operating room when you are asleep from general anesthesia. A doctor or emergency medical technician can make a tracheostomy safely at a patient’s bedside, such as in the intensive care unit (ICU), or elsewhere in a life-threatening situation. A tracheostomy usually takes 20 to 45 minutes to perform. The surgeon or other health care professional will make a cut through the lower front part of your neck and then cut into your windpipe. Cuffed trach tubes may be used. These tubes use air to widen or narrow the tube to fit the hole. After inserting and placing the trach tube into the windpipe, the surgeon or other health care professional will use stitches, surgical tape, or a Velcro band to hold the tube in place.
After getting the tracheostomy, you may stay in the hospital to recover depending on your health. It can take up to two weeks for a tracheostomy to fully form, or mature. During this time, you will not be able to eat normally and will likely receive nutrients through a feeding tube. You may have difficulty talking after your tracheostomy. A speech therapist can help you to regain normal swallowing ability and use your voice to speak clearly. Your trach tube will be removed when you no longer need it. The hole usually closes on its own, but surgery can close the hole if needed.
Tracheostomy is a fairly common and simple procedure, especially for critical care patients in hospitals. Soon after the procedure, it is possible to have bleeding, infection, pneumothorax or collapsed lung, or subcutaneous emphysema. Over time, complications may include windpipe scarring or an abnormal connection, called a fistula, between the windpipe and esophagus that causes food and saliva to enter your lungs. It is also possible to have complications that affect the function of the trach tube, such as the tube slipping or falling out of place, or that affect the windpipe or other airway structures. Proper care and handling of the tracheostomy, the tubes, and other related supplies can help reduce risks.
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