Situations that may call for a tracheostomy include:
- Medical conditions that require the use of a breathing machine (ventilator) for an extended period, usually more than one or two weeks
- Medical conditions that block or narrow your airway, such as vocal cord paralysis or throat cancer
- Paralysis, neurological problems or other conditions that make it difficult to cough up secretions from your throat and require direct suctioning of the windpipe (trachea) to clear your airway
- Preparation for major head or neck surgery to assist breathing during recovery
- Severe trauma to the head or neck that obstructs breathing
- Other emergency situations when breathing is obstructed and emergency personnel can't put a breathing tube through your mouth and into your trachea
Most tracheotomies are performed in a hospital setting. However, in the case of an emergency, it may be necessary to create a hole in a person's throat when outside of a hospital, such as at the scene of an accident.
Emergency tracheotomies are difficult to perform and have an increased risk of complications. A related and somewhat less risky procedure used in emergency care is a cricothyrotomy. This procedure creates a hole directly into the voice box (larynx) at a site immediately below the Adam's apple (thyroid cartilage).
Once a person is transferred to a hospital and stabilized, a cricothyrotomy is replaced by a tracheostomy if there's a need for long-term breathing assistance.
Aug. 17, 2016
- What is a tracheostomy? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/trach. Accessed March 7, 2016.
- Hall JB, et al. Tracheostomy. In: Principles of Critical Care. 4th ed. New York: The McGraw-Hill Companies; 2015. http:// accessmedicine.com. Accessed March 9, 2016.
- Hyzy RC. Overview of tracheostomy. http://www.uptodate.com/home. Accessed March 9, 2016.
- Bair AE. Emergent surgical cricothyrotomy (cricothyroidotomy). http://www.uptodate.com/home. Accessed March 9, 2016.
- Airway establishment and control. Merck Manual Professional Version. http://www.merckmanuals.com/professional/critical-care-medicine/respiratory-arrest/airway-establishment-and-control. Accessed March 11, 2016.
- Flint PW, et al. Tracheotomy. In: Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed March 15, 2016.
- Clinical consensus statement: Tracheostomy care. American Academy of Otolaryngology — Head and Neck Surgery. http://oto.sagepub.com/content/148/1/6. Accessed March 15, 2016.