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What is a tracheostomy?

A tracheostomy is a surgery to make a small opening through the front of your child’s neck and into the windpipe (trachea). A tube is then placed through the opening and into the windpipe. The tube keeps your child’s airway open and helps your child breathe by allowing air to flow into and out of the lungs.

The terms tracheostomy, tracheotomy, and trach may be used to refer to both the surgical procedure and to the opening created by the procedure.

When is it used?

A tracheostomy may be done when your child has a problem with the airway. For example, it may be done if:

  • Your child has an injury or a condition that makes it hard to breathe, cough up the mucus in the airways, or swallow.
  • Your child will be on a breathing machine for a long time.

A tracheostomy may be done as an emergency or as a planned procedure. It may be temporary or your child may have it for life.

How do I prepare my child for this procedure?

  • Your child may or may not need to take his regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that your child takes. Some products may increase the risk of side effects. Ask your healthcare provider if your child needs to avoid taking any medicine or supplements before the procedure.
  • Tell your healthcare provider if your child has any food, medicine, or other allergies such as latex.
  • Your child’s provider will tell you when your child needs to stop eating and drinking before the procedure. This helps to keep your child from vomiting during the procedure.
  • Tell your child’s provider if your child has an infection, like a cold.
  • Follow any other instructions your child’s healthcare provider may give you.
  • Ask any questions you have before the procedure. You should understand what your child’s healthcare provider is going to do. You have the right to make decisions about your child’s healthcare and to give permission for any tests or procedures.

What happens during the procedure?

This procedure is usually done in a hospital. In rare cases, it may be done at the scene of an accident.

Your child will be given medicine called anesthesia so your child doesn’t feel pain during the surgery. Depending on the medicine, your child may be awake or asleep during the procedure.

Your child’s healthcare provider will make a cut in the front of your child’s neck and into the windpipe. Your provider will then put a tube through the cut and into the windpipe. The tube will be held in place with stitches and cloth ties or Velcro straps that go around your child’s neck. The stitches will be removed later.

Your provider may connect a breathing machine to the tracheostomy tube.

What happens after the procedure?

Depending on your child’s condition, your child may stay in the hospital for a few days or weeks. If your child will still have the trach after going home from the hospital, your healthcare provider will teach you how to care for it.

If your child no longer needs it after a time, your provider will remove the tube and allow the opening to close on its own. If the opening hasn’t closed by itself in 4 to 6 months, your provider may close it with minor surgery.

Follow your child’s healthcare provider's instructions. Ask your provider:

  • How long it will take for your child to recover
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

  • Your child may have problems with anesthesia.
  • Your child may have an infection or bleeding.
  • Your child may have damage to the voice box or problems with swallowing.

Ask your child’s healthcare provider how the risks apply to your child. Be sure to discuss any other questions or concerns that you may have.

Written by Robert Brayden, MD, Clinical Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2015.3 published by RelayHealth.
Last modified: 2015-03-02
Last reviewed: 2014-04-24
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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