Tracheostomy Care Guidelines
Description
A tracheostomy is the formation of an opening into the trachea usually
between the second and third rings of cartilage.
Indications for Tracheostomy
o Facilitate weaning from mechanical ventilation by decreasing
anatomical dead space.
o Prevention / treatment of retained tracheo-bronchial secretions.
o Chronic upper airway obstruction
o Bypass acute upper airway obstruction
Types of Tracheostomy
The tracheostomy may be temporary or long term, and may be formed
electively or as an emergency procedure.
A temporary tracheostomy can be formed when patients require long term
respiratory support or are unable to protect their own airways. A tracheostomy
tube will be inserted to maintain the patency of the airway. This can be
removed when the patient recovers.
A temporary tracheostomy may become long term if the patient’s condition
requires this.
A permanent tracheostomy is created where the trachea is brought out to the
surface of the skin and sutured to the neck wall. This stoma is kept open by
the rigidity of the tracheal cartilage. The patient will breathe through this
stoma for the remainder of his/her life. As a result, there is no connection
between the nasal passages and the trachea.
This procedure is elective and the patients need to be carefully prepared for
the consequences of the procedure.