A tracheotomy is a surgical opening through the neck into the throat. The opening is called a stoma or tracheostomy. It may be temporary or permanent.
A tube called a tracheotomy tube will be inserted into the tracheotomy. Air may pass directly through this tube or tubing will be attached to a machine that assists in breathing.
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A tracheotomy is done to open a new pathway for air to move into the lungs. Breathing is impaired by damage or illness in the upper airways from:
A tracheotomy may also be done if long-term mechanical ventilation is needed. A tracheotomy allows for greater movement, the ability to eat and drink by mouth, and the ability to speak while receiving ventilation. It can also prevent aspiration of food and liquids into the lungs.
Problems from the procedure are rare, but all procedures have some risk. Your child’s doctor will review potential problems, like:
Your child’s doctor will do the following before the tracheotomy:
Talk to your child’s doctor about all medications your child uses. Your child may need to stop taking some medications prior to the procedure.
General anesthesia will be used. Your child will be asleep during the procedure.
A cut will be made in the skin of the neck. A section at the front of the windpipe will be removed. A tracheostomy tube will then be fitted into this opening in the windpipe. Depending on the situation, an inflatable cuff may be part of the tube. The cuff is most important when the tube is being used for mechanical ventilation, to keep air going into the lungs and not leaking into the mouth. The skin will be closed with stitches or clips.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The length of stay will depend on the reason for the procedure. Most stays are 1-5 days.
Right after the procedure, your child will be in a recovery room where their blood pressure, pulse, and breathing will be monitored. Recovery may also include pain or anti-nausea medications.
The tracheostomy tube will be used for breathing as long as it is in place. The hospital staff will make sure the tracheostomy tube is working properly. In some cases, a chest x-ray can be used to evaluate the tracheostomy tube.
During your child’s stay, the hospital staff will take steps to reduce their chance of infection such as:
There are also steps you can take to reduce your child’s chances of infection such as:
Tracheostomy tubes need to be cared for on a regular basis. The hospital staff will teach you how to care for your child’s tracheostomy tube. It is important follow the staff’s instructions to prevent infection and airway obstruction. Other specialists will help your child adjust to the tracheotomy and learn how to speak and eat with the tracheostomy.
Tracheostomy tube care considerations include:
Call your child's doctor if any of these occur:
Call for emergency medical services right away if:
If you think your child has an emergency, call for emergency medical services right away.
American Pediatric Surgical Association
The Society of Thoracic Surgeons
Caring for Kids—Canadian Paediatric Society
The College of Family Physicians of Canada
About the procedure. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/tracheostomy/about/index.html. Accessed December 20, 2017.
Deutsch ES. Tracheostomy: pediatric considerations. Respir Care. 2010;55(8):1082-1090.
Frequently asked questions (FAQ) about tracheotomy and swallowing. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/slp/clinical/frequently-asked-questions-on-tracheotomy-and-swallowing. Accessed December 20, 2017.
Things to avoid when your child has a trach. St. Jude Children’s Research Hospital website. Available at: https://www.stjude.org/treatment/patient-resources/caregiver-resources/patient-family-education-sheets/tracheostomy-care/things-to-avoid-when-your-child-has-a-trach.html. Accessed December 20, 2017.
Tracheotomy care handbook. Cincinnati Children’s website. Available at: https://www.cincinnatichildrens.org/health/t/tracheotomy-handbook. Accessed December 20, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP