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TRACHEOSTOMY — ARTIFICIAL AIRWAY FOR BREATHING

Dr. T.N.C. Padmanabhan, Friday, October 25, 2019

WHAT IS A TRACHEOSTOMY?

A tracheostomy is an opening cut into the windpipe or trachea. It is used as an airway for breathing. After the opening is made, a small tube is inserted to let air in and to attach a breathing machine (mechanical ventilator) if needed. Mucus can more easily be coughed up and out or removed with a suction catheter.


WHAT IS A TRACHEOSTOMY TUBE?

A tracheostomy tube is a small tube inserted into the tracheostomy to keep the stoma (opening) clear.

Tracheostomy tubes are available in several sizes and materials including semi-flexible plastic, rigid plastic or metal. The tubes are disposable or reusable. They may have an inner cannula that is either disposable or reusable. The tracheostomy tube may or may not have a cuff. Cuffed trach tubes are generally used for patients who have swallowing difficulties or who are receiving mechanical ventilation. Non-cuffed trach tubes are used to maintain the patient’s airway when a ventilator is not needed. The choice of tube is based on your condition, neck shape and size, and purpose of the tracheostomy.

All trach tubes have an outer cannula (main shaft) and a neck-plate (flange). The flange rests on your neck over the stoma (opening). Holes on each side of the neck-plate allow you to insert trach tube ties to secure the trach tube in place.


WHY WOULD SOMEONE NEED A TRACHEOSTOMY?

Some reasons a person may need a tracheostomy to include:

  • Having a breathing tube for one to two weeks and on a machine, that helps a patient to breathe (a ventilator)
  • Having mucus in the lungs and not being able to cough strongly enough to remove it
  • An allergic reaction that has made the airway swell and possibly close
  • Surgery of the head or neck


HOW IS A TRACHEOSTOMY BETTER THAN AN ENDOTRACHEAL TUBE?

Advantages of the tracheostomy include:

  • More comfort
  • Easier cleaning of the mouth and face
  • May allow swallowing and the ability to eat and drink
  • May allow speech with the help of a speaking device
  • May help weaning from the ventilator
  • May reduce swelling in the airway and mouth caused by having an endotracheal tube in place for a long time

 

CAN A PERSON SPEAK WITH A TRACHEOSTOMY?

There are devices that can help some patients speak. The device can be put over the end of the tracheostomy tube. When the patient takes a breath, the valve opens to let air into the lungs. When the patient breathes out, the valve closes. Then all the air passes through the vocal cords and out of the mouth or nose. The movement of air through the vocal cords lets the patient speak as long as he or she can take a deep enough breath to push air through the windpipe.

Not all patients who have a tracheostomy tube can use a speaking device. The patient can be evaluated by the health care team to decide if this is possible. Specific instructions will be given if the patient is able to use a speaking device.


HOW IS THE TRACHEOSTOMY TUBE REMOVED?

When the patient no longer needs the tracheostomy tube, the doctor may cover the opening with a plug to test the patient’s breathing for a period of time. Once the tube is removed, the hole in the skin will be covered with sterile gauze. The wall of the windpipe and the hole in the skin may close in time. Occasionally, depending on why the tracheostomy was performed, the hole is permanently left open. This hole is called a stoma.


WHY KIMS?

At KIMS, one of the best Intensive Care Hospitals in Hyderabad, we strive to provide state of the art and compassionate care for patients with tracheostomy. We realize that caring for a loved one with a tracheostomy is not an easy task.

We have standardized the tracheostomy change using a procedure that is extremely safe. Our team, with our best Pulmonary Intensivist doctors in Hyderabad, works collaboratively with other KIMS specialists to provide the most comprehensive multidisciplinary care possible for our patients.

We hope our skill, knowledge and innovative approach provides you with the service you need. To reach you better, our Pulmonology Specialist Hospital in Kondapur is equipped to care for adults as well as pediatric patients with tracheostomy.

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