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A tracheostomy is an artificial surgical opening into the wind-pipe (trachea) via the neck providing a channel for effective breathing (respiration) and the removal of ‘tracheobronchial secretions’, when circumstances make breathing impossible via the mouth and nose.
There are a variety of reasons your child may need to have a tracheostomy your ear, nose and throat (ENT) consultant will explain this to you as part of the consent process.
Your child will be anaesthetised and whilst asleep the ENT surgeon will make a small cut (incision) in your child’s neck at the front.
A tracheostomy tube will be inserted and secured in place with some white cotton tape which is tied at the side of your child’s neck.
The internal size of the tracheostomy tube will depend on the size of your child.
Your child will be nursed on the High Dependency Unit (HDU) or Intensive Care Unit (ICU) for the first few days following creation of their tracheostomy. They will then be transferred to a ward.
Their neck will be painful to begin with but the nurses will give your child regular pain relief.
The minimum stay is 2 weeks but this may vary depending upon the reason your child had the tracheostomy, how quickly they recover from the operation and how quickly you feel confident to look after them on your own without any help from nursing staff.
You will be given a training booklet by the ENT nurse specialist which tells you about the different things you need to learn before you can take your child home.
The ENT nurse specialist and the nursing staff on the ward will teach you everything you need to know.
Eating and drinking may need some adjustment initially following the operation, and may need some specialist input from our Speech and Language Therapy team. Eventually, most children will be able to eat and drink normally providing there are no medical reasons to prevent this.
Due to the fact that the tracheostomy tube is situated below your child’s voice box they will not be able to make any sounds or speak. As the swelling from the surgery goes down and your child grows, air is able to go around the tracheostomy tube. This allows the vocal cords to vibrate so that your child can make sounds.
If the reason that your child had their tracheostomy involved a problem with their voice box then it may be longer before they are able to make sounds. These children are often taught to communicate using sign language.
Once the community nurse has trained a member of staff at your child’s school, nursery or playgroup to look after your child’s tracheostomy safely, then they will be able to go.
There is usually no reason why you are not able to take your child on holiday either in this country or abroad. Your ENT consultant will advise you about this.
Your child should not go swimming under any circumstances.
If your child is older and participates in an unusual sport or hobby please ask your ENT consultant before allowing them to return to this activity.
Before your child is discharged home the ENT nurse specialist will contact the community nurses who work in your area. This will make sure that they will visit you regularly and give you any advice and support you need once your child leaves hospital.
This depends upon the reason that your child had their tracheostomy. You will be given this information before your child is discharged home.
This depends upon the reason that your child had their tracheostomy formed.
Generally the ENT consultant will strive to remove the tracheostomy tube before your child starts school.
The nursing staff are trained to replace the tracheostomy tube if this happens.
The likelihood of this happening is reduced by a device which goes over your child’s tracheostomy tube called a humidifier. This enables them to breathe in warm, moist air which reduces the likelihood of the tube becoming blocked.
Some bleeding from around the tracheostomy site is to be expected for the first few days following the insertion of the tracheostomy tube. You may also notice that the secretions which come out of the tracheostomy tube are slightly bloodstained. Again this is to be expected for the first few days
The risk of this is reduced by regular cleaning and treatment with antibiotics if this does occur.
Your child may develop a collection of air underneath their skin around the tracheostomy tube. This collection is called surgical emphysema and usually resolves on its own without the need for any treatment.
Tracheostomy UK Support Facebook group
Association for Children who have a Tracheostomy (ACT)
Email: AlisonJAllan@yahoo.co.uk
The Patient Resources page from the National Tracheostomy Safety Project has a wealth of information on your child’s tracheostomy.
Please read our resource for more information about risks of anaesthetics.
Hospital switchboard
Available 24 hours every day
0114 271 7000 (main hospital number)
ENT nurse specialist
Monday to Friday, 9am to 5pm
Call 0114 271 7000 and ask to bleep 573
Call 0114 226 0511 (answer machine)
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
Resource number: ENT5
Resource Type: Article
Western Bank
Sheffield
S10 2TH
United Kingdom
Switchboard: 0114 271 7000
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