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.