CHECK-UP:Tracheotomies are required for many different reasons, writes MARION KERR.
What is a tracheotomy? My friend was in an accident and has one and although I’ve seen them done on medical soaps I’m not really sure what it involves.
A tracheotomy is a surgical procedure whereby a tube is placed in an opening in the neck to allow a person to breathe and to remove secretions from the lungs.
Under general anaesthesia, an incision is made in the neck to expose the tough cartilage rings that make up the outer wall of the trachea. An opening is then created and a tracheotomy tube is inserted.
Tracheotomies are required for a variety of reasons including severe mouth or neck injuries following an accident, where a large object is blocking the airway, paralysis of the muscles that affect swallowing or an abnormality of the larynx or trachea. Those with cancer of the neck or mouth may also require a tracheotomy as may someone who is unconscious or in a coma.
Will she be able to talk with it in place?
It can take a few days for a person with a tracheotomy to get used to breathing with it. Although initially it may not be possible to make a sound or speak with a tube in place, with training it is possible to learn how to talk. In the meantime, some other means of communication, such as writing or signing, is usually required.
Are they always permanent or can they be removed?
Tracheotomies can be permanent or temporary depending on the cause of the problem and the needs of the individual.
Where a tracheotomy is temporary, once the tube is removed the opening quickly heals leaving minimal scarring.
For others, surgical closure may be required when a need for the tracheotomy has gone. Where a breathing tube is required on a permanent basis, the opening will remain open and they and/or their carers will be shown how to manage the device.
The tracheotomy tube must be cleaned regularly and suction is usually required to remove secretions from the upper airways. To prevent the secretions and mucus becoming think and sticky, a humidifier may be helpful. Water must be kept out of the opening as it may get directly into the lungs.
A shirt or scarf may be used to cover the opening but it must be of a thin material, allowing air to get through while preventing loose fibres and dust entering the opening. Many people with a permanent tracheotomy can resume normal activities, once they are careful about exposure to aerosols, powder, food particles and water.