What is a tracheostomy?

A tracheostomy is surgery to make a small opening through the front of your neck and into your windpipe (trachea). A tube is then placed through the opening and into your windpipe. The tube keeps your airway open and helps you breathe by allowing air to flow into and out of your lungs.

The terms tracheostomy, tracheotomy, and trach may be used to refer to both the surgical procedure and to the opening created by the procedure.

When is it used?

A tracheostomy may be done when you have a problem with your airway. For example, it may be done if:

• You have an injury or a condition that makes it hard to breathe, cough up the mucus in your airways, or swallow.
• You will be on a breathing machine for a long time.

A tracheostomy may be done as an emergency or as a planned procedure. It may be temporary or you may have it for life.

How do I prepare for this procedure?

Your healthcare provider will talk about your choices for treatment and explain the procedure and any risks. You should understand what your provider is going to do and how long it will take you to recover. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

For a tracheostomy that is not an emergency, ask your healthcare provider if there are instructions you need to follow before surgery. Your instructions may include:

• Changes to how you take your medicines
• What you can eat and drink before surgery
• Quitting smoking if you smoke
• Other steps to follow before surgery

Tell your healthcare provider if you have any food or medicine allergies. Also tell your provider about all medicines and supplements that you take.

Talk to your provider about what happens after the procedure, such as:

• Caring for the tracheostomy
• Taking medicines to relieve pain, prevent infection, or treat other problems
• Avoiding some activities for a while
• Symptoms or problems to watch for and what to do if you have them
• When you can return to your normal activities
• When you should come back for a checkup

What happens during the procedure?

This procedure is usually done in a hospital. In rare cases, it may be done at the scene of an accident.

You will be given medicine called anesthesia to keep you from feeling pain. Depending on the medicine, you may be awake or asleep during the procedure.

Your healthcare provider will make a cut in the front of your neck and into the windpipe. Your provider will then put a tube through the cut and into the windpipe. The tube will be held in place with stitches and cloth ties or Velcro straps that go around your neck. The stitches will be removed later.

Your provider may connect a breathing machine to the tracheostomy tube.

What happens after the procedure?

Depending on your condition, you may stay in the hospital for a few days or weeks. If you will still have the trach when you go home from the hospital, your healthcare provider will teach you or your caregiver how to care for it.

If you no longer need the trach after a time, your provider will remove the tube and allow the opening to close on its own. If the opening hasn’t closed by itself in 4 to 6 months, your provider may close it with minor surgery.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Problems with anesthesia
• Infection or bleeding
• Damage to the voice box
• Problems with swallowing

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.