Tracheostomy

A tracheostomy is when an opening is made in your windpipe (trachea). This is done through the skin in your neck. A tracheostomy tube is inserted through the hole to keep it open. This means that when you breathe, air can pass through this tube instead of having to go through the nose or mouth.

(A tracheotomy is when you make the hole in the trachea without putting in the tube.)

You might need one if:

• you have a narrow windpipe
• your airway is obstructed
• you need to clean or to remove fluid from the lower chest
• you need to be given oxygen easily.

You’ll get to wear a hospital gown and then you will be wheeled to the operating suite.

You may be given an intravenous line (a drip) and you will have heart and oxygen equipment attached to you so that staff can keep an eye on everything during the operation.

You will be given a general anaesthetic that makes you fall into a deep sleep and you will not be aware of the operation happening.

The anaesthetist will stay with you throughout the operation to make sure that your heart rate and blood pressure are normal.

The surgeon will make a small cut (known as an incision) into the skin around your throat and the lower part of your neck. He will then insert the tracheostomy tube into this hole.

Cotton tapes keep the tube in place. An oxygen supply can be attached to the tube and if you cannot breathe on your own, your tube will be attached to a ventilator. After the operation you might find it difficult to eat but the nursing staff taking care of you will help you.

Sometimes people find it hard to swallow properly after a tracheostomy. It can take a while to get used to but usually it just takes time. If the problem doesn’t go away you may have to see a speech and language therapist for some help.

It can be hard to get used to but with practice most people (who are not on ventilators) can talk with tracheostomies.

The surgery takes around 30 minutes but it will also take time to put you to sleep and then to wake you up. In total it will take about an hour.

You will have to talk to your doctor about this. Some people will only have it for a short time and others may have it for a long time or forever. The hole which the surgeon makes grows smaller over time and if you have a tracheostomy for a long time you may need to have surgery to open the hole up properly again.

You will be asleep during the operation and won’t feel any pain. Afterwards it may hurt a bit until it has healed. Some young people complain about a mild discomfort around the neck. Paracetamol should help to make this feel a bit better.

•  You must not get water in the tube. When you have a bath, make sure the water level is well below the tracheostomy. You can have a shower but be careful not to splash water in the tube. Keep a pump close by just in case.
• Don’t go swimming and be careful when paddling or near water.
• Wear clothes that aren’t too tight around the tracheostomy. Try not to wear clothes that are very woolly. Otherwise fluff might get into the tube.
• Talk to your doctor about pets. Animal fur can sometimes enter the tracheostomy. Pets that live in sawdust floored cages can also cause problems.
• Keep away from smokers and aerosols. When you breathe in smoke or fumes they will go straight to your lungs and cause irritation.
• Keep a bell by your bed in case you need some help in the night.