Adult Tracheostomy Trauma
What is a tracheostomy?
A tracheostomy is an opening in the lower neck that goes into the trachea. The trachea or “windpipe” is the tube that leads into your lungs. A doctor will make this opening during a brief surgery. The doctor places a small plastic hollow tube called a tracheostomy tube or “trach” tube in the opening. When a person breathes through a trach tube, the air then moves into the trachea and lungs, instead of the nose and mouth.
Why is a tracheostomy done?
A trach is usually done for one of five reasons:
- if the airway above the trachea is blocked or damaged
- if there are frequent or large amounts of mucous that need to be removed from your lungs
- if your lungs need a safer and easier way to get oxygen
- if there has been, or may be, long term use of a breathing tube in the mouth
- to make it easier to get off the breathing machine
If there has been a breathing tube in the mouth for a long time, a trach can provide you with more comfort. The head and neck can move more freely, and it will be easier to keep your mouth clean and moist.
How is a trach cared for?
The trach tube put in during surgery will be changed to a new tube 7 to 10 days later. After that the tube will be changed when needed.
The nurses will clean around the opening (stoma) two to three times a day as needed.
People that have a trach need extra moisture in their lungs to keep the mucous in the lungs thin and easy to cough up. A small mask placed over the trach can give mist to help with this. The nurses will also suction through the trach tube to remove extra mucous when you need it.
Will I be able to communicate?
If you have a Cuffed trach tube (see picture below), you will not be able to speak at all. This is because the cuff allows very little air to flow around the trach to the vocal cords. The cuff is inflated so that it has a snug fit in the airway. This helps to prevent food or fluid from entering the lungs. It can also help the breathing machine (ventilator) give stronger breaths since air can’t leak around the trach tube. We will work with you to learn other ways to communicate such as picture boards or writing boards.
The tube will remain in as long as you need it for breathing help. Once the doctors are able to put in a smaller tube, speaking may be possible. If the trach is no longer needed it can be removed and the hole will heal into a very small scar. When the trach is removed your voice will return to normal if your vocal cords are working normally.
If you have a Non-Cuffed trach tube, your trach does not have a balloon. When your doctor has switched to this type of trach tube you may be able to talk with a speaking valve, or by placing a finger or cap over the end of the trach tube.
How do I care for the trach site after the trach comes out?
The trach site will heal in only a few days. It can be covered with gauze and an occlusive dressing until it heals, this will protect the opening as it closes. This dressing can be changed daily and as needed. You may need to apply pressure to the site with your fingers over the dressing in order to talk for the first day or two. When it is healed there is no need for a dressing.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/18/2012
Copyright © 09/18/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6690
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