A tracheostomy tube is a small tube placed in a patient's trachea (windpipe) through the neck. The tracheostomy tube is an artificial airway.
The following description refers to adult intensive care patients.
How is it done?
In Intensive Care tracheostomy tubes are usually used for two reasons. Firstly if the patient is going to be on a breathing machine for a prolonged period (more than 10 days). Another maybe if a patient has problems swallowing correctly and secretions are getting into their lungs (called aspiration).
The surgical procedure of inserting a tracheostomy tube into a patient's trachea is called a tracheotomy. This procedure is performed in the Operating Theatre by a Surgeon using the ‘open’ technique or in the Intensive Care Unit by an Intensive Care Doctor, called a percutaneous tracheotomy. In either case an opening is made through the neck into the trachea (windpipe) and the tracheostomy tube is inserted into the hole and directed down towards the lungs. The patient’s doctors will decide which is the most appropriate method and this be discussed along with possible complications when obtaining consent to perform the procedure.
How Does It Work?
When a patient has a tracheostomy tube air passes through the tube into the patient’s lungs. In addition secretions from the upper airways (mouth, nose and throat) are prevented from getting into the lungs by a small cuff around the tube. The tracheostomy also allows clinical staff to remove secretions such as sputum from the patient’s lungs more easily.
In Intensive Care most patients will have a tracheostomy tube as a temporary measure until the patient’s acute illness is over. When a patient is on a breathing machine (ventilator) for a prolonged period a tracheostomy tube can make it easier for them to breath as well as providing easier access for clinicians to clean a patient’s mouth. If a patient is unconscious they may have difficulty keeping their airway clear and swallowing properly. Tracheostomy tubes prevent air from passing through the voice box so patients are unable to speak. However under some circumstances a special trache tube is used which can allow the patient to speak.
Once the reason/s for having the trache tube have resolved the patient will go through a weaning process and the tube will be removed. This weaning process is supervised by the intensive care team. A small number of patients are discharged from ICU with a trache tube still in. When this happens there is a special team of doctors, nurses, physiotherapists and speech pathologists who help the patient - this may take from days to months.
Once the trache tube is removed the hole will close over and the person will be able to breathe normally.
Are There Any Complications?
All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. Please discuss these issues with the medical and nursing staff who are caring for the patient.
Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.
Please note these translations are based on an earlier version of this description.
Tracheostomy Tube Version 2
Original version published in June 2008
This version published February 2008
Author: Kaye Rolls CNC ICCMU
The figure below was sourced from: http://www.cpem.org/html/giflist.html
The information contained on this page is general in nature and therefore cannot reflect individual patient variation. In addition it reflects Australian intensive care practice which may differ from other countries. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. ICCMU attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.