It is often, but not always, done in an emergency.
The procedure may be temporary or permanent depending on individual circumstances.
Different situations may warrant slightly different techniques.
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The procedure itself can be performed fairly quickly (in 20 to 45 minutes).
This may not be possible in the event of an emergency.
If a puncture technique is used this is called a percutaneous tracheostomy rather than an open tracheostomy.
When the tube is removed the opening heals in about a week.
Anatomical structures such as the laryngeal nerves, or esophagus can also potentially be injured during a tracheostomy.
This is managed using humidified air and irrigation.
Discomfort can also be minimized by preventing movement of the tube.
As previously mentioned tracheitis is common during the recovery period.
Adequate fluid intake and humidified oxygen are helpful in thinning secretions and making them easier to suction.
Medications such as guaifenesin may also be used to control secretions.
Initially a cuffed tracheostomy tube will be used right after the tracheostomy is performed.
Speaking may be encouraged after you no longer need mechanical ventilation.
It may take practice to learn to speak with a tracheostomy.
If this is the case you will be instructed on how to care for your tracheostomy at home.
Depending on circumstances this care may be performed by family members, home health staff or nurses.
The tracheostomy tube itself may need to be changed periodically.
The dressings around the trach tube may also need to be regularly changed and immediately if they become wet.
Sometimes special creams or foam dressings are first applied to help the skin in this area.
The tube should be removed as soon as possible for the best outcomes.
Your ability to control your own secretions is also monitored during this time.
The actual removal of the tube is called decannulation.
You will probably still have to cover the stoma with a finger to speak for a while.
The stoma typically heals in five to seven days after the tube is removed.
In this case the stoma can be closed surgically.
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Published July 11, 2011.
