What is a tracheostomy?
A tracheostomy is a surgical procedure in which a small
opening is made in the lower neck into the trachea or
“windpipe.” A small, plastic hollow tracheostomy or
“trach” tube is placed through this hole making an airway
to provide oxygen and remove secretions from the lungs.
When a person breathes through a trach tube, the air
moves directly into the trachea and then into the lungs.
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 such as after a traumatic injury to your
face or neck.
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
If there has been, or may be, long term use of a
breathing tube in the mouth.
To make it easier to wean or “get off” the breathing machine (ventilator.)
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 2 weeks after insertion. This may be done
at the bedside. After that, the tube will be changed when needed.
The nurses will clean around the opening (stoma) three times a day and 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 with humidified oxygen will be placed over the trach 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 first while
the cuff needs to be inflated. 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, more
efficient 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.
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 long will I need the trach?
The tube will remain in as long as you need it to help you breathe. As your breathing improves,
the doctors will put in a smaller tube. Once you no longer need the breathing machine
(ventilator) or cpap, we can try to deflate your cuff and apply a speaking valve to the end of your
trach. You will still breathe through your trach with this speaking valve on. If you do well with
this, we can try capping your trach which will allow you to breathe from your mouth into your
lungs again. If you are able to tolerate your trach being capped for 24-48 hours and you have no
surgeries scheduled for the near future, your doctor may decide to remove your trach.
How do they remove the trach if I no longer need it?
The doctor simply pulls the trach out and places a small occlusive dressing over the trach site.
You may feel a slight discomfort at first but this goes away quickly after the trach is out. Once
the trach is removed, your voice will return to normal if your vocal cords are working normally.
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 heals closed. 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 while the site is healing and to keep it from
blowing off when you cough. When the site is healed, there is no need for a dressing.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 11/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6690