What Is a Trach Tube?

A trach or tracheostomy tube is a 2- to 3-inch-long metal or plastic tube that is curved and placed into a surgically created hole in the neck called a stoma. The tube provides an airway to the lungs and aids in removing secretions from the lungs. It also provides a connection if you need to be put on a breathing machine when you can't breathe on your own, opens an airway if your windpipe is blocked and helps reduce swelling caused by mouth surgery.

Parts

The outer cannula of the trach tube is placed inside the stoma and keeps the hole from closing up. A removable inner cannula lies inside of the outer tube and can be changed or cleaned as needed.

Why a Trach Tube

A trach tube helps improve a patient's oxygen flow when the mouth or upper throat is blocked. It helps in removing mucus secretions and in keeping the airway open. Trach tubes are inserted whenever the passage of air to the lungs may be blocked due to swelling or damage to the mouth and throat. Surgeons also insert trach tubes when mouth cancer blocks the airway or in cases of congenital abnormalities, swallowing muscle paralysis, neck cancer or a severely damaged mouth or throat. Trach tubes can also be used to help maintain breathing when a patient aspirates a toxic or damaging substance.

Preparing the Tube

The patient is anesthetized, the neck is cleaned and draped and the surgeon makes cuts to expose the cartilage rings around the outer wall of the trachea. The surgical team then cuts through the trachea to create an opening for the tube.

Inserting the Tube

A removable part called the obturator is placed over the end of the tube as a guide when inserting the outer cannula of the tube into the stoma. Once securely in place, a balloon-like cuff might be inflated around the tube if you are on a breathing machine or have problems with choking. It is inflated through a small inflation tube and acts to seal the tube inside the stoma to reduce air leakage. Some trach tubes have no cuff.

Care of the Tube

The tube must be cleaned at least once or twice a day. The inner cannula is removed, cleaned and reinserted. The area around the tube should be kept loosely covered when outside and not submerged or exposed to water, aerosol sprays, food particles, dust or powder.

Adjustment

Patients with a new trach tube installation may take up to three days to adjust to breathing through the tube. Talking will be difficult if not impossible. Some patients manage to learn to talk with a stoma using adaptive equipment or whisper speech. Patients should return to their normal routine as soon as possible to promote the adjustment process.

Risks

If the tracheostomy is temporary, the stoma should heal up quickly once the tube is removed. If the trach tube has been in for a long time, surgery may be needed to close the opening. The stoma should, in any case, leave very little scarring. Infection around the stoma can occur if proper cleaning and maintenance of the trach tube is not performed. There exists a very slight risk of erosion to the trachea from friction with the trach tube. Nerve damage and scar tissue can develop in some cases. The patient should report any unusual thickness or numbing around the site of the stoma to his physician.

References

• Tracheostomy
• Tracheostomy Tubes