What Are Tracheostomies?
Tracheostomies are surgically created holes that pass from the front of the neck into the trachea, or windpipe. It is created to allow patent airway access and adequate breathing for the patient.
Tracheostomies may be temporary in the case of airway emergencies or may be used for long-term access to airway and breathing depending on a patient’s condition or overall health.
Why is There a Need for Improvement in Tracheostomy Care?
Several hundred patients die of tracheostomy-related events annually in the US. Most deaths occur at home and are potentially preventable with better patient and family education, coordinated care and support. In addition, because tracheostomies require care from multiple specialties, patients often experience disorganized, fragmented and needlessly expensive care.
The Global Tracheostomy Collaborative believes that through collective research and education, we can improve tracheostomy care worldwide.
Learn more in this article by Dr. David Roberson and Dr. Gerry Healy posted in the American College of Surgeons Bulletin:
The Global Tracheostomy Collaborative: Multidisciplinary quality improvement in tracheostomy care
Common Terms
- Tracheotomy, tracheostomy: People often use these terms interchangeably. Technically, the suffix –otomy, means “to cut into”. The suffix -ostomy means “opening into”. So, a tracheotomy is the surgical procedure to create a tracheostomy, or the opening into the trachea, or windpipe.
- Cannula, inner: the part of the tracheostomy tube that can be removed and cleaned or replaced.
- Cannula, outer: the part of the tracheostomy tube that stays in place.
- Cuff: the balloon at the end of the tracheostomy tube.
- Decannulation: removal of the tracheostomy tube.
- Fenestrated tracheostomy tube: The word fenestration comes from the French word, la fenêtre, meaning ‘window’. A fenestration is an opening on the shaft of the tube that allows air to pass through it. When it is fit properly, it can allow people to speak.
- Flange, phalange: the part of the tracheostomy tube that fixed against the neck.
- Inflation Line: the tubing that connects the pilot balloon with the cuff.
- Laryngectomee: person who has had a laryngectomy.
- Laryngectomy: removal of the larynx, (vocal cords, or voicebox).
- Mucus plug: an accumulation of mucus that can obstruct the airway.
- Obturator: the removable piece of the tracheostomy tube that functions only to insert the tube. It should be always available in case the tube accidentally comes out.
- Pilot Balloon: a balloon that is attached to the cuff. When the balloon is inflated, there is air in the cuff. When the balloon is completely flat, there is no air in the cuff.
- Speaking valve: usually a one-way valve that fits on the tracheostomy tube. It allows air to pass into the tracheostomy, but closes on exhalation, forcing air into the mouth and nose, allowing speech. It should only be used on a cuffless tube, or one with a fully deflated cuff.
- Stoma: literally means “mouth”. It refers to the skin around the opening.
- Suctioning: removal of tracheal secretions.
- Heat Moisture Exchanger, HME: a device that fits on the tracheostomy tube and collects exhaled water vapor, allowing it to be inhaled, increasing humidity.
- Phonation: using the voice