Search - Tracheostomy

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Description

Tracheostomy is a procedure to create an opening in the neck to access the trachea and insert a hollow tube to help in breathing. The tube may be connected to an oxygen supply source or to a ventilator. In most cases, tracheostomy is a temporary procedure and the tube is removed after breathing becomes normal. It is one of the most frequently performed procedures in critically ill patients. Tracheostomy decreases airway resistance and the patientís dependence on mechanical ventilation may also be reduced.

Symptoms

Tracheostomy is recommended when: The upper airway is blocked/obstructed due to swelling, tumor, injury, infection, burn or a foreign object that cannot be removed Secretions/fluids have to be removed from the airway as in case of serious lung infection or when blood is filled in the airway due to a major injuryInability to breath normally as due to a severe injury, when there is damage to lungs as is cystic fibrosis or when the swallowing muscles are paralyzed There is need for long term mechanical ventilation as in comatose patients The upper airway is blocked/obstructed due to swelling, tumor, injury, infection, burn or a foreign object that cannot be removed Secretions/fluids have to be removed from the airway as in case of serious lung infection or when blood is filled in the airway due to a major injury Inability to breath normally as due to a severe injury, when there is damage to lungs as is cystic fibrosis or when the swallowing muscles are paralyzed There is need for long term mechanical ventilation as in comatose patients

Pre Procedure

Tracheostomy is usually performed in emergency situations in an ICU or in an operating room.

During Procedure

Tracheostomy is performed under general anesthesia. However in an emergency situation, when there is no time to give general anesthesia, the procedure may be performed under local anesthesia. The patientís heart rhythm and oxygen saturation are continuously monitored during the procedure. An incision is made in the neck, an opening is made in the middle of the trachea and then a tracheostomy tube is inserted in this opening below the larynx.

Post Procedure

The patient will take a few days to adapt to breathing and talking with a tracheostomy tube.If the patient is on ventilation, then speaking will not be possible. The initial tube placed at the time of surgery may be changed after a few days. Antibiotics are given to reduce the risk of infection. Before leaving the hospital, the tracheostomy tube may be removed and the opening will be closed.However when the tube is needed for a long period of time, home care instructions on changing & cleaning the tube and suctioning the trachea will be given. People gradually adapt to a normal lifestyle with a permanent tracheostomy tube. The patient will take a few days to adapt to breathing and talking with a tracheostomy tube. If the patient is on ventilation, then speaking will not be possible. The initial tube placed at the time of surgery may be changed after a few days. Antibiotics are given to reduce the risk of infection. Before leaving the hospital, the tracheostomy tube may be removed and the opening will be closed. However when the tube is needed for a long period of time, home care instructions on changing & cleaning the tube and suctioning the trachea will be given. People gradually adapt to a normal lifestyle with a permanent tracheostomy tube.

Risk And Complications

There is risk of reaction to anesthetic medications, excessive bleeding, infection and nerve injury during the procedure. Rarely, the voice box or larynx may be damaged and rarely the tracheostomy tube may erode the surrounding structures.Air may be trapped around the lungs or in the chest.There may be scarring of the neck. There is risk of reaction to anesthetic medications, excessive bleeding, infection and nerve injury during the procedure. Rarely, the voice box or larynx may be damaged and rarely the tracheostomy tube may erode the surrounding structures. Air may be trapped around the lungs or in the chest. There may be scarring of the neck.
Hospital

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