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Tracheostomy—Adult

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  • Editorial Staff and Contributors
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Procedure

Tracheostomy—Adult

(Tracheotomy)

Definition

A tracheostomy is a surgery to make an opening in the neck. The opening is called a tracheotomy. It creates a path from the outside of the neck into the windpipe. A tube is often placed into the opening.

Tracheostomy

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Reasons for Procedure

Illness or injury can make it hard for air to move through the upper airway. A tracheostomy makes a new path for air to pass through. It is most often done for people who need long-term breathing help from a machine. It may be needed for a short time or for the rest of a person's life. A tracheostomy may be done because:

  • The airway is blocked because of:
    • Trauma to the mouth or neck area
    • Tumors or infections in the upper airway
    • Vocal cord paralysis
    • Removal of part of the throat to treat cancer—laryngectomy
  • Respiratory failure that has caused a need for machine help to breathe may be caused by:
    • Spinal cord injury in the neck area
    • Severe lung infection or swelling
  • Amachine is needed to help with breathing for more than 2 to 3 weeks
  • Injury to the airway due to breathing in smoke, steam, or a harmful chemical
  • Birth defects of the throat or airways
  • Object blocking the throat or airways
  • Severe sleep apnea
  • Problems with inhaling food or drink into lungs because of muscle or loss of feeling in the throat

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Bleeding
  • Infection
  • Damage to the vocal cords, vocal cord nerves, or the tube that goes to your stomach
  • Scarring that can cause problems at the opening or tube to the lungs
  • Tube may fall out of place or be damaged
  • Problems swallowing
  • Air gets trapped under the skin of the neck
  • Damage to the lungs
  • Low blood pressure
  • Abnormal connection of tube to stomach or nearby blood vessels

Some things that may raise the risk of problems are:

  • Age—infants and older adults have higher risks
  • Obesity
  • Smoking
  • Poor nutrition
  • Recent illness, especially an upper respiratory infection
  • Alcohol use disorder
  • Long term illnesses
  • Use of some medicines or recreational drugs

What to Expect

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Specialists you may need to see
  • Tests that will need to be done before surgery

Anesthesia

The doctor may give:
  • General anesthesia—you will be asleep
  • Local anesthesia—this is used in an emergency, and the area would be numbed

Description of Procedure

An incision will be made in the skin at the lower part of the front of your neck. The doctor will then be able to see the windpipe. A hole will be made in the windpipe. A tracheostomy tube will be placed into the hole. The tube will have wings that spread out along the skin. It will be stitched to the skin. A strap will be attached to the wings and placed around the neck to help keep the tube in place.

Immediately After Procedure

You will breathe through this tube as long as it is in place. Oxygen and machines to help with breathing will be used, if needed. A chest x-ray may be needed.

How Long Will It Take?

About 15 to 30 minutes

Will It Hurt?

Anesthesia will block pain during the procedure. You may have some pain and soreness after. Medicine can help.

Average Hospital Stay

The length of stay will depend on the reason for the procedure. Most stays are one to five days.

Post-procedure Care

At the Hospital

During your stay, staff will take steps to lower your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
You can also lower your chance of infection by:
  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

The care team will teach you how to clean and care for your tracheostomy tube to help prevent infection and let air flow freely.

Problems to Look Out For

Call your doctor if you have:

  • Signs of infection, such as cough, bad-smelling mucous, fever, or chills
  • Redness, swelling, more pain, a lot of bleeding, or any discharge from the tracheotomy site
  • Nausea or vomiting that will not go away
  • Pain that you cannot control with the medicines given
  • Cough, shortness of breath, or chest pain
  • Symptoms that get worse

Call for emergency medical help right away if:

  • Your tracheostomy tube falls out and you cannot put it back in
  • You are having trouble breathing through your tube

If you think you have an emergency, call for medical help right away.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Patient education: teaching the patient with a tracheostomy. EBSCO Nursing Reference Center Plus website. Available at: https://www.ebsco.com/health-care/products/nursing-reference-center-plus.
  • Tracheostomy. National Heart Lung and Blood Institute. Available at: https://www.nhlbi.nih.gov/health/lung-treatments.
  • Tracheostomy in Adults. American Thoracic Society website. Available at: https://www.thoracic.org/patients/patient-resources/resources/tracheostomy-in-adults-1.pdf.
  • Tracheostomy in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/tracheostomy-in-adults.
Last Updated:
2023-06-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.