Living with a tracheostomy can present unique challenges, but with the right knowledge and support, individuals can lead fulfilling lives. In this comprehensive blog, we aim to demystify tracheostomy, shedding light on its purpose, the procedure itself, recovery process, and long-term implications. Whether you’re a patient, caregiver, or simply curious about this vital medical intervention, this guide will equip you with the knowledge needed to navigate the world of tracheostomy with confidence and understanding. Let’s embark on a journey to uncover the intricacies of tracheostomy and its profound impact on breathing and quality of life. 

What is tracheostomy? 

A tracheostomy is an opening/hole through the neck into the windpipe. Tracheostomy is done to aid the patient in breathing which has developed complications in breathing through the nose (and even mouth) because of various reasons explained. The need for tracheostomy decides its duration if it can be weaned off or not. 

Tracheostomy is done via a surgical procedure, usually by a team of doctors, in which a tube is inserted via a cut placed in the neck just below the vocal cords. It allows air to enter the lungs and hence breathing occurs via tube instead of the mouth, nose, and throat. 

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Which patients need tracheostomy? 

You may need a tracheostomy if you: 

  • Have an obstruction in your upper airway (nose, mouth or throat). 
  • Have difficulty swallowing. 
  • Have trouble breathing due to injury, swelling or lung conditions. 
  • Undergo airway reconstruction following surgery on your larynx (voice box) or pharynx (throat). 
  • Need mechanical ventilation (breathing machine) for more than a week. 

How is tracheostomy done? 

The tracheostomy procedure is typically performed under general anesthesia in a hospital setting. During the procedure, a small incision is made in the neck, and a tube is inserted into the trachea to create the stoma.  

Is a tracheostomy Painful? 

The procedure to create a tracheostomy, is typically performed under anesthesia, so the person undergoing the procedure does not feel pain during the surgery. However, there may be some discomfort or soreness in the throat area after the procedure, which can be managed with pain medication. Additionally, there may be some discomfort associated with having a tracheostomy tube in place, but this can vary from person to person and often improves over time as the person adjusts to the tube. 

Why is tracheostomy a critical procedure? 

Several tracheostomies are done every year and at times. But still, tracheostomy is critical because of its very aim to ensure proper air to lungs. If proper tracheostomy care is not received by the patient, it will lead to serious complications. 

Yes, complications can be a part of every surgical procedure. But in this case, it can be life-threatening within a few minutes and mostly can be resolved only by a specialist. If proper instructions are not followed or even if some disease appears suddenly, it may complicate the prevailing situation. 

Following complications can appear anytime in the later stages of tracheostomy and requires proper training to take care of the situation: 

  • Acute airway obstruction 
  • Blocking of tube including mucous plugging or occluded cannula 
  • Aspiration 
  • Tracheal trauma or even infection at the hole 
  • Tracheal stenosis 
  • Dislodging of the tube 

What are the advantages of Tracheostomy? 

In an emergency, a tracheostomy may be the only option rather than just the best one. In this scenario, the primary advantage of this procedure is that it allows the patient a chance to live. When there is no other option, first responders should not hesitate to perform an emergency tracheostomy if it is part of agency protocol, because all other considerations pale in comparison to the possibility of dying.  

Some advantages of tracheostomy outside of the emergency medicine setting include:  

  • It may allow a person with chronic breathing difficulties to talk.  
  • It may eliminate the need for care in an intensive care unit.  
  • It builds a more stable airway that is less likely to suffer serious injuries.  
  • It may improve breathing. This may speed healing and improve outcomes in people with chronic, long-term medical conditions.  
  • It may reduce the need for sedation and eliminate the need for masks and other facial equipment, potentially improving relationships and quality of life.  
  • It may enable a person who was on a feeding tube to again eat by mouth.  

What are disadvantages of tracheostomy? 

  • Tracheostomy disadvantages include potential complications like infection and discomfort, impaired speech, ongoing care needs, psychological impact, and the risk of long-term dependence. 

Can a person still talk after tracheostomy? 

Yes, a person can still talk after a tracheostomy, although the ability to speak may be affected depending on the type of tracheostomy tube used and the individual’s condition. Some tracheostomy tubes have special valves that allow air to pass through the vocal cords, enabling speech. Alternatively, speaking valves or other devices can be used to redirect airflow from the tracheostomy tube to the vocal cords, allowing the person to produce speech. Speech therapy may also be helpful in regaining or improving communication skills after a tracheostomy. 

Is a Tracheostomy permanent? 

A tracheostomy can be temporary or permanent, depending on the reason of the use. Reason for a permanent tracheostomy tube may include an underlying long term, progressive condition such as ALS. Other conditions are those with irreversible damage to the structure of the larynx or both recurrent laryngeal nerves, resulting in inability to breathe through the upper airway. 

When to remove tracheostomy tube? 

A tracheostomy tube is removed when a person no longer needs help breathing. This might be a few days or weeks, but some people need it for longer. When a tracheostomy is no longer needed, it’s allowed to heal shut or is surgically closed. The stoma will naturally heal from the inside of the body (windpipe) to the outside, with the part you can see on your neck healing last. 

Can a person recover from tracheostomy? 

Yes, many people can recover from a tracheostomy. The duration of the tracheostomy depends on the underlying condition and the individual’s response to treatment. Once the condition improves or resolves, the tracheostomy tube can be removed, and the tracheostomy site can heal. Rehabilitation and support may be needed to help regain normal respiratory function and adjust to life after the tracheostomy. 

How long can a person stay on a tracheostomy? 

The duration a person stays on a tracheostomy depends on various factors such as the underlying medical condition, the reason for the tracheostomy, and how well the person responds to treatment. In some cases, a tracheostomy may only be needed temporarily, until the person’s condition improves, and they can breathe independently again. In other cases, a tracheostomy may be needed long-term or permanently if the person has chronic respiratory issues or if they are unable to breathe without assistance. Ultimately, the decision to remove the tracheostomy tube is made by the medical team based on the individual’s progress and overall health status. 

Must Read: Tracheostomy Care: What It Is, Recovery & Nursing Care

How long can you live with a tracheostomy? 

According to research, tracheostomy doesn’t shorten your life expectancy. But this doesn’t take underlying conditions into the account. 

Which is better ventilator or tracheostomy? 

Both ventilators and tracheostomies serve different purposes in managing respiratory issues. Ventilators provide temporary mechanical breathing support, while tracheostomies offer a more long-term solution by creating a direct airway access. The choice depends on the patient’s condition, with ventilators often used for short-term respiratory support and tracheostomies for longer-term needs.