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Having a tracheostomy

What is a tracheostomy?

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.

Why does my child need a tracheostomy?

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.

What does the operation involve?

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.

Illustration diagram of tracheostomy in child's throat

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.

Illustration of child with tracheostomy tube coming out of their throat

What is recovery like following the operation?

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.

How long will my child stay in hospital after the operation?

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.

How do I care for my child at home?

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.

Will my child be able to eat normally?

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.

Will my child be able to speak?

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.

Can my child go to school, nursery or playgroup?

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.

Will I be able to take my child on holiday?

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.

Is there anything my child will be unable to do?

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.

Will anyone be able to help me at home?

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.

How often will my child need to return to hospital?

This depends upon the reason that your child had their tracheostomy. You will be given this information before your child is discharged home.

When will the tracheostomy be removed?

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.

What complications may occur after the operation?

The tracheostomy tube may come out

The nursing staff are trained to replace the tracheostomy tube if this happens.

The tracheostomy tube may become blocked with secretions

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.

Bleeding from around the tracheostomy site

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 tracheostomy site may become infected

The risk of this is reduced by regular cleaning and treatment with antibiotics if this does occur.

Air underneath the skin

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.

Are there any support groups for children with tracheostomies?

Tracheostomy UK Support Facebook group

Association for Children who have a Tracheostomy (ACT)

Email: AlisonJAllan@yahoo.co.uk

Are there any other resources for information on tracheostomy in children?

The Patient Resources page from the National Tracheostomy Safety Project has a wealth of information on your child’s tracheostomy.

Further resources

Please read our resource for more information about risks of anaesthetics.

Contacts for more advice

Sheffield Children’s NHS Foundation Trust

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)

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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.

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