subject: Tracheostomy Care Basics [print this page] A tracheostomy is a surgically created hole in the front of a person's windpipe (trachea), on the neck region, in which a breathing tube is inserted. Breathing is accomplished through the inserted tube, rather than the nose and mouth. The procedure to create the tracheostomy is called a tracheotomy, but sometimes the terms are used interchangeably. The procedure may be needed during an emergency, when a person's airway is blocked or as a planned procedure to assist breathing. Most are required for long-term health problems, which need assisted breathing.
Paralysis, head or neck surgery, trauma and throat blocking diseases (cancer) may warrant this procedure. Surgical is most common, but the type of the procedure depends on whether it's planned or an emergency situation. Surgical route requires general anesthesia, while a minimally invasive route uses local anesthetic to numb the throat and neck region.
After a tracheostomy, a nurse will train a patient to clean and change the inserted device. Daily care prevents infection. The device contains two parts, an outer tube and an inner tube (canola). The two parts are locked together and sometimes the outer tube is surgically sewn into the skin on the neck. The inner tube can be unlocked and removed to facilitate daily cleaning. Gauze is commonly used to protect skin from secretions at the tracheal opening (stoma) during the cleaning procedure. Home medical products assist with skin protection, cleaning and tracheostomy inner-tube replacements.
A second important aspect of care includes prevention of breathing tube blockage. Mucus secretions become thicker after the procedure because dry air no-longer passes through moist nasal cavities and throat. The dryness causes irritation, coughing and excess mucus production. Humidification of breathed air helps decrease mucus production, but usually home medical products are needed to suction excess mucus through the tubing.
As with any medical procedure, complications can occur. Medical help is required when neither suctioning nor coughing improves impaired breathing. Mucus blockage is life-threatening. Also, if the tracheostomy stoma appears to have pus or is red and swollen, an infection may be present. Fever indicates an infection as well.
Homecare medical supplies needed for proper care include: sterile gloves, gauze, replacement inner tracheostomy tubes, suction machine, suction tubing and suction catheters. Precise cleanliness and careful adherence to proper procedures will ensure continued functionality of the inserted device. A tracheostomy is usually temporary and when breathing ability returns, the tubes are removed and the stoma is closed.
