All supplies/devices that are imperative and requisite for tracheostomy care must be placed at the bedside prior to beginning the procedure. In addition, a container having 0.9% sodium chloride solution, a suction kit, and sterile gloves are also the prerequisites. The velcro leash that holds the tracheostomy tube firmly in place may need to be replaced on its being soiled.
The patient must be preoxygenated before the suction process. If the patient is excited, a sedative can be administered or the procedure should be rescheduled for some other day when the patient is calm. Pain drugs may also be applied, particularly during the first few days post surgery when the incision can cause discomfort.
A chest X-ray is often imperative, particularly in children, to confirm if the tube has been displaced or if complications have unearthed. Warm compresses can be facilitated to alleviate pain at the incision site. The patient surrounding should be dry. It is suggested that the patient should cover the opening when going outside. Contact with water, food particles, and powdery material should be avoided. The tracheotomy tube needs to be changed from four to 10 days after surgery.
Healing will occur fast, leaving minimal scar. Often a stricture, or stiffness of the trachea may develop, which can also affect breathing. If the tracheostomy tube is not temporary, the cavity may require surgical process to close it.
Most patients need 1 to 3 days to learn to breathe through a tracheostomy tube. Initially it may be tough for the patient to make sounds. If the tube permits some air to escape and pass though the vocal cords, then the patient may be in a position to speak by holding the tube. Special tracheostomy tubes are also available facilitating speech. After training and practice, patients can adapt to talk with a tracheostomy tube.
Normal lifestyles can be resumed after sometime. When outside, a loose scarf on the tracheostomy stoma (hole) is suggested to protect any infection or injury. Patients should comply with other safety precautions pertaining to exposure to powder, water, aerosols, or food particles.
In case the tracheotomy is temporary the tube will be removed and the wound will heal rapidly and only a small scar may be left. In case of permanent tracheotomy, the hole will be left open and, if in case it is not required, it will be surgically ceased.