trek breathing tube

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• Tracheostomy

A tracheostomy is a surgically created hole (stoma) in your windpipe (trachea) that provides an alternative airway for breathing. A tracheostomy tube is inserted through the hole and secured in place with a strap around your neck.

Tracheostomy (tray-key-OS-tuh-me) is a hole that surgeons make through the front of the neck and into the windpipe (trachea). A tracheostomy tube is placed into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy.

A tracheostomy provides an air passage to help you breathe when the usual route for breathing is somehow blocked or reduced. A tracheostomy is often needed when health problems require long-term use of a machine (ventilator) to help you breathe. In rare cases, an emergency tracheotomy is performed when the airway is suddenly blocked, such as after a traumatic injury to the face or neck.

When a tracheostomy is no longer needed, it's allowed to heal shut or is surgically closed. For some people, a tracheostomy is permanent.

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Why it's done

Situations that may call for a tracheostomy include:

• Medical conditions that make it necessary to use a breathing machine (ventilator) for an extended period, usually more than one or two weeks
• Medical conditions that block or narrow your airway, such as vocal cord paralysis or throat cancer
• Paralysis, neurological problems or other conditions that make it difficult to cough up secretions from your throat and require direct suctioning of the windpipe (trachea) to clear your airway
• Preparation for major head or neck surgery to assist breathing during recovery
• Severe trauma to the head or neck that obstructs breathing
• Other emergency situations when breathing is obstructed and emergency personnel can't put a breathing tube through your mouth and into your trachea

Emergency care

Most tracheotomies are performed in a hospital setting. However, in the case of an emergency, it may be necessary to create a hole in a person's throat when outside of a hospital, such as at the scene of an accident.

Emergency tracheotomies are difficult to perform and have an increased risk of complications. A related and somewhat less risky procedure used in emergency care is a cricothyrotomy (kry-koe-thie-ROT-uh-me). This procedure creates a hole directly into the voice box (larynx) at a site immediately below the Adam's apple (thyroid cartilage).

Once a person is transferred to a hospital and stabilized, a cricothyrotomy is replaced by a tracheostomy if there's a need for long-term breathing assistance.

Tracheostomies are generally safe, but they do have risks. Some complications are particularly likely during or shortly after surgery. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure.

Immediate complications include:

• Damage to the trachea, thyroid gland or nerves in the neck
• Misplacement or displacement of the tracheostomy tube
• Air trapped in tissue under the skin of the neck (subcutaneous emphysema), which can cause breathing problems and damage to the trachea or food pipe (esophagus)
• Buildup of air between the chest wall and lungs (pneumothorax), which causes pain, breathing problems or lung collapse
• A collection of blood (hematoma), which may form in the neck and compress the trachea, causing breathing problems

Long-term complications are more likely the longer a tracheostomy is in place. These problems include:

• Obstruction of the tracheostomy tube
• Displacement of the tracheostomy tube from the trachea
• Damage, scarring or narrowing of the trachea
• Development of an abnormal passage between the trachea and the esophagus (tracheoesophageal fistula), which can increase the risk of fluids or food entering the lungs
• Development of a passage between the trachea and the large artery that supplies blood to the right arm and right side of the head and neck (tracheoinnominate fistula), which can result in life-threatening bleeding
• Infection around the tracheostomy or infection in the trachea and bronchial tubes (tracheobronchitis) and lungs (pneumonia)

If you still need a tracheostomy after you've left the hospital, you'll need to keep regularly scheduled appointments for monitoring possible complications. You'll also receive instructions about when you should call your doctor about problems, such as:

• Bleeding at the tracheostomy site or from the trachea
• Difficulty breathing through the tube
• Pain or a change in comfort level
• Redness or swelling around the tracheostomy
• A change in the position of your tracheostomy tube

How you prepare

How you prepare for a tracheostomy depends on the type of procedure you'll undergo. If you'll be receiving general anesthesia, your doctor may ask that you avoid eating and drinking for several hours before your procedure. You may also be asked to stop certain medications.

Plan for your hospital stay

After the tracheostomy procedure, you'll likely stay in the hospital for several days as your body heals. If possible, plan ahead for your hospital stay by bringing:

• Comfortable clothing, such as pajamas, a robe and slippers
• Personal care items, such as your toothbrush and shaving supplies
• Entertainment to help you pass the time, such as books, magazines or games
• A communication method, such as a pencil and a pad of paper, a smartphone, or a computer, as you'll be unable to talk at first

What you can expect

During the procedure.

A tracheotomy is most commonly performed in an operating room with general anesthesia, which makes you unaware of the surgical procedure. A local anesthetic to numb the neck and throat is used if the surgeon is worried about the airway being compromised from general anesthesia or if the procedure is being done in a hospital room rather than an operating room.

The type of procedure you undergo depends on why you need a tracheostomy and whether the procedure was planned. There are essentially two options:

• Surgical tracheotomy can be performed in an operating room or in a hospital room. The surgeon usually makes a horizontal incision through the skin at the lower part of the front of your neck. The surrounding muscles are carefully pulled back and a small portion of the thyroid gland is cut, exposing the windpipe (trachea). At a specific spot on your windpipe near the base of your neck, the surgeon creates a tracheostomy hole.
• Minimally invasive tracheotomy (percutaneous tracheotomy) is typically performed in a hospital room. The doctor makes a small incision near the base of the front of the neck. A special lens is fed through the mouth so that the surgeon can view the inside of the throat. Using this view of the throat, the surgeon guides a needle into the windpipe to create the tracheostomy hole, then expands it to the appropriate size for the tube.

For both procedures, the surgeon inserts a tracheostomy tube into the hole. A neck strap attached to the face plate of the tube keeps it from slipping out of the hole, and temporary sutures can be used to secure the faceplate to the skin of your neck.

After the procedure

You'll likely spend several days in the hospital as your body heals. During that time, you'll learn skills necessary for maintaining and coping with your tracheostomy:

• Caring for your tracheostomy tube. A nurse will teach you how to clean and change your tracheostomy tube to help prevent infection and reduce the risk of complications. You'll continue to do this as long as you have a tracheostomy.
• Speaking. Generally, a tracheostomy prevents speaking because exhaled air goes out the tracheostomy opening rather than up through your voice box. But there are devices and techniques for redirecting airflow enough to produce speech. Depending on the type of tube, width of your trachea and condition of your voice box, you may be able to speak with the tube in place. If necessary, a speech therapist or a nurse trained in tracheostomy care can suggest options for communicating and help you learn to use your voice again.
• Eating. While you're healing, swallowing will be difficult. You'll receive nutrients through an intravenous (IV) line inserted into a vein in your body, a feeding tube that passes through your mouth or nose, or a tube inserted directly into your stomach. When you're ready to eat again, you may need to work with a speech therapist, who can help you regain the muscle strength and coordination needed for swallowing.
• Coping with dry air. The air you breathe will be much drier because it no longer passes through your moist nose and throat before reaching your lungs. This can cause irritation, coughing and excess mucus coming out of the tracheostomy. Putting small amounts of saline directly into the tracheostomy tube, as directed, may help loosen secretions. Or a saline nebulizer treatment may help. A device called a heat and moisture exchanger captures moisture from the air you exhale and humidifies the air you inhale. A humidifier or vaporizer adds moisture to the air in a room.
• Managing other effects. Your health care team will show you ways to care for other common effects related to having a tracheostomy. For example, you may learn to use a suction machine to help you clear secretions from your throat or airway.

In most cases, a tracheostomy is temporary, providing an alternative breathing route until other medical issues are resolved. If you need to remain connected to a ventilator indefinitely, the tracheostomy is often the best permanent solution.

Your health care team will help you determine when it's appropriate to remove the tracheostomy tube. The hole may close and heal on its own, or it can be closed surgically.

Tracheostomy care at Mayo Clinic

• Brown AY. Allscripts EPSi. Mayo Clinic. Aug. 28, 2019.
• Tracheostomy. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/tracheostomy. Accessed Sept. 23, 2019.
• Tracheostomy and ventilator dependence. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/tracheostomies/. Accessed Sept. 19, 2019.
• Surgical airway. Merck Manual Professional Version. https://www.merckmanuals.com/professional/critical-care-medicine/respiratory-arrest/surgical-airway#. Accessed Sept. 23, 2019.
• Roberts JR, et al., eds. Tracheostomy care. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Sept. 23, 2019.
• Patton J. Tracheostomy care. British Journal of Nursing. 2019; doi:10.12968/bjon.2019.28.16.1060.
• Mitchell RB, et al. Clinical consensus statement: Tracheostomy care. Otolaryngology — Head and Neck Surgery. 2013; doi:10.1177/0194599812460376.
• Landsberg JW. Pulmonary and critical care pearls. In: Clinical Practice Manual for Pulmonary and Critical Care Medicine. Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 25, 2019.
• Rashid AO, et al. Percutaneous tracheostomy: A comprehensive review. Journal of Thoracic Disease. 2017; doi:10.21037/jtd.2017.09.33.
• Moore EJ (expert opinion). Mayo Clinic. Oct. 1, 2019.
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Tracheostomy

A tracheostomy (also called a tracheotomy) is a procedure where a hole is made at the front of the neck. A tube is inserted through the opening and into the windpipe (trachea) to help you breathe.

Why a tracheostomy is done

Reasons you may need to have a tracheostomy include:

• to help you breathe if your throat is blocked
• to remove excess fluid and mucus from your lungs
• to deliver oxygen from a machine called a ventilator to your lungs

A tracheostomy is often planned in advance, but sometimes it needs to be done as soon as possible in an emergency.

If you need a tracheostomy but are unable to give your consent , it will be discussed with your family.

What happens during a tracheostomy

A tracheostomy is usually done under general anaesthetic , so you'll be asleep during the operation and will not feel any pain.

If it needs to be done in an emergency, you'll have a local anaesthetic , where you'll be awake but your neck will be numb.

The surgeon makes a cut in the skin at the front of your neck and creates a small hole in your windpipe.

A tracheostomy tube is inserted through the hole and into your windpipe. It's held in place by a piece of tape around your neck.

You breathe through the tracheostomy tube rather than through your nose and mouth.

After the operation

You'll need to stay in hospital for a while after having a tracheostomy. How long depends on why you had the procedure and your recovery.

Some people only need a tracheostomy for a few days, while others need it for much longer.

If you're able to go home with a tracheostomy, you or the person looking after you will be shown how to clean and care for it before you leave hospital. You'll also be given help and support after you've left.

After having a tracheostomy

It may take a while to get used to having a tracheostomy.

Tracheostomy tubes often have an air-filled cuff around them. You will not be able to speak when the cuff is inflated.

To begin with, you may need to communicate using writing and gestures.

As you recover, air will gradually be removed from the cuff and you'll be able to start to speak.

A speaking valve is sometimes fitted to the tracheostomy tube, which can help make your voice stronger.

Eating and drinking

You may be able to eat and drink with a tracheostomy.

But if you cannot swallow, you may need to have a thin feeding tube inserted through your nose and down into your stomach.

This allows liquid food and fluids to be given to you directly.

Changing your tracheostomy tube

Your tracheostomy tube may need to be changed if it's been in for 28 days or you need a different tube to help with your breathing and talking.

Changing the tube is a quick and simple procedure that's usually done in hospital.

Removing your tracheostomy tube

Your tracheostomy tube will be removed when you no longer need help breathing. This might be a few days or weeks, but some people need it for longer.

A dressing will be put over the hole after the tube has been removed. The hole usually takes about 7 to 10 days to heal.

You may have some pain or discomfort in the area where the tube was, but this should improve as the hole heals.

You'll also have a small scar on your neck, but it will fade over time.

Risks and complications of a tracheostomy

A tracheostomy is a common procedure, but as with any type of surgery there are risks and possible complications.

Your doctor will discuss these with you before you agree to have a planned tracheostomy.

Risks of a tracheostomy include:

• bleeding in or around the tracheostomy
• damage to the windpipe or area around it
• the tracheostomy tube becoming blocked or moving out of place
• problems with the hole healing after the tube is removed, such as it becoming infected
• a build-up of air between your lungs and chest wall, which can cause pain, difficulty breathing or a collapsed lung in severe cases

Urgent advice: Call NHS 111 or get an urgent GP appointment if:

You're at home after having a tracheostomy and:

• you're having problems swallowing
• you're coughing or being sick after eating or drinking
• your breathing is noisy during the day or at night (including snoring)
• your scar is raised or uncomfortable
• you have pain or discomfort around the area of the tracheostomy, particularly when swallowing
• your voice is hoarse or weak for more than a week

You may be referred to a specialist so they can investigate these problems further.

Immediate action required: Call 999 if:

You've had a tracheostomy and:

• you're having difficulty breathing

Page last reviewed: 26 January 2024 Next review due: 26 January 2027

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Living with a tracheostomy

By: My Vanderbilt Health

February 28, 2022

If you or a loved one suddenly needs a tracheostomy, you may have questions.

A tracheostomy is an opening created in the neck so that a tube can be placed in the trachea, often called the windpipe, to aid breathing. A tracheostomy, or “trach,” may be needed if you have a blockage in your airway or severe lung disease, or for other reasons. Living with a tracheostomy can take some time to adapt to, but you can still enjoy a good quality of life. And in some cases, a tracheostomy may only be needed temporarily during a recovery period.

“We’re one of the highest volume airway centers in the country that specializes in disorders of the voice box and the trachea,” explained Alexander Gelbard, M.D., an otolaryngologist with Vanderbilt Center for Complex Airway Reconstruction . “And we really take a team approach that can provide a high level of personalized care to improve people’s recovery from severe illness.”

Understanding Complex Airway Disorders

Download our guide to learn about various disorders and their symptoms, diagnosis for complex airway disorders, and surgical and nonsurgical treatment options.

Reasons for a tracheostomy

To breathe, air must pass your vocal cords and move down your windpipe. Then it moves into your lungs, where it hops across a thin membrane in your alveoli to get into your bloodstream, Gelbard explained. If you have problems along the way at any one of those points, he added, you can feel like you’re not getting enough air.

“People who develop scarring on their vocal cords or trachea after having a breathing tube,” Gelbard said, “can feel like they’re short of breath. And they need a tracheostomy to bypass the blockage.”

Additionally, some people with advanced lung disease may also need a tracheostomy to help supply extra pressure and oxygen at night to support breathing if their lungs are weakened.

Tracheostomy care at home

Your care team will teach you and any caregivers how to maintain the tracheostomy. Tracheostomy care will include regularly cleaning the skin at the tracheostomy site and the stoma, which is the hole where the tube inserts into your neck. Cleaning is crucial to prevent irritation and infection and to keep your tracheostomy functioning properly. Another task is suctioning. Suctioning helps remove mucus plugs that you’re unable to cough up.

Some aspects of living with a trach will take some time to get used to. One consideration is that you may have difficulty smelling and tasting your food. “If there’s not a lot of air passing your nose,” Gelbard explained, “it can be tough to smell. And a lot of times when you don’t smell well, your sense of taste is off.” Some people with a tracheostomy will require a feeding tube for nutrition, however.

“There’s also a psychologic impact of having to live with this airway prosthesis,” Gelbard added. “It can affect body image for some people. And that can take a lot of adjustment.” He said he spends a lot of time in the office talking with his tracheostomy patients about this aspect if it’s affecting them.

Although some people may need a tracheostomy long term or permanently, others may only require one for a short time as part of recovery after an illness like COVID-19 .

“Decisions about tracheostomy often occur when you’re battling severe illness,” Gelbard said. “A tracheostomy can be really necessary to help you recover and move out of the hospital.” But once someone has moved out of the hospital and has gone through rehab and started to recover, their situation may change. “They should seek out an otolaryngologist to talk about if they still need to have their tracheostomy,” Gelbard explained. Even if you do need a tracheostomy long term, see a specialist who sees a lot of patients with tracheostomies. “This can be of benefit,” he said, “to help find an airway prosthesis that fits best and functions the highest to really keep you breathing, talking and swallowing optimally.”

Vanderbilt Health’s specialists in the Complex Airway Reconstruction Program  have the expertise to accurately evaluate, diagnose and treat a wide array of complex airway disorders. Our comprehensive team works with you to develop a personalized care plan, so you can swallow, speak and breathe with ease. Call 615-343-0540 for more information.

Sign up for updates on My Vanderbilt Health

Expert Health Articles

Intubation vs. Tracheostomy

When you hear a physician say that you or a loved one needs to be intubated or needs a tracheostomy, it is important to understand the purpose of these and how they differ.

A tracheostomy (trach) is a procedure in which a doctor surgically makes an incision in the trachea, sometimes called the “windpipe.” Tracheostomy procedures are performed when there is an obstruction in the airway and intubation is medically not possible, a patient has inefficient oxygen delivery or has problems with secretions.

Once the incision is made, a tube is placed in the windpipe. This tube holds the airway open and allows air to move in and out of the lungs. When a trach is placed, one may be able to breathe without a breathing machine, also known as a ventilator, or a ventilator may be needed.

When a tracheostomy is no longer needed, it can be removed and allowed to heal on its own, or the physician may close it surgically. Patients can be discharged home with a trach; but with that, comes new learning experiences. A trained respiratory therapist or a professional nurse will help you and your family learn to care for the trach.

Intubation (or being intubated) is the process in which a breathing tube is placed into the mouth and down the throat to provide oxygen via a machine. Intubation is done when one cannot maintain their airway on their own due to anesthesia or illness. Often, a person is intubated for a short time, and a person would not go home when they are intubated. Patients cannot be discharged with intubation and must have medical supervision.

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Tracheostomy care

A tracheostomy is surgery to create a hole in your neck that goes into your windpipe. If you need it for just a short time, it will be closed later. Some people need the hole for the rest of their life.

The hole is needed when your airway is blocked, or for some conditions that make it hard for you to breathe. You may need a tracheostomy if you are on a breathing machine (ventilator) for a long time; a breathing tube from your mouth is too uncomfortable for a long-term solution. The tracheostomy provides a way for your health care providers to gradually remove the ventilator if possible.

After the hole is made, a plastic tube is placed in the hole to keep it open. A ribbon is tied around the neck to keep the tube in place.

When You're in the Hospital

Before you leave the hospital, health care providers will teach you how to do the following:

• Clean, replace, and suction the tube
• Keep the air you breathe moist
• Clean the hole with water and mild soap or hydrogen peroxide
• Change the dressing around the hole

Do not do strenuous activity or hard exercise for 6 weeks after surgery. After your surgery, you may not be able to speak. Ask your provider for a referral to a speech therapist to help you learn to talk with your tracheostomy. This is usually possible once your condition improves.

After you go home, follow instructions on how to care for your tracheostomy. Use the information below as a reminder.

You will have a small amount of mucus around the tube. This is normal. The hole in your neck should be pink and painless.

It is important to keep the tube free of thick mucus. You should always carry an extra tube with you in case your tube gets plugged. Once you put in the new tube, clean the old one and keep it with you as your extra tube.

When you cough, have a tissue or cloth ready to catch the mucus coming from your tube.

Your nose will no longer keep the air you breathe moist. Talk with your provider about how to keep the air you breathe moist and how to prevent plugs in your tube.

Some common ways to keep the air you breathe moist are:

• Putting a wet gauze or cloth over the outside of your tube. Keep the gauze moist.
• Using a humidifier in your home when the heater is on and the air is dry.

A few drops of salt water (saline) will loosen a plug of thick mucus. Put a few drops in your tube and windpipe, then take a deep breath and cough to help bring up the mucus.

Protect the hole in your neck with a cloth or tracheostomy cover when you go outside. These covers can also help keep your clothes clean from mucus and make your breathing sounds quieter.

Do not breathe in water, food, powder, or dust. When you take a shower, cover the hole with a tracheostomy cover. You will not be able to go swimming.

To speak, you will need to cover the hole with your finger, a cap, or a speaking valve.

Sometimes you can cap the tube. Then you might be able to speak normally and breathe through your nose and mouth.

Caring for Your Tracheostomy

Once the hole in your neck is not sore from the surgery, clean the hole with a cotton swab or a cotton ball at least once a day to prevent infection.

The bandage (gauze dressing) between your tube and neck helps catch mucus. It also keeps your tube from rubbing on your neck. Change the bandage when it is dirty, at least once a day.

Change the ribbons (trach ties) that keep your tube in place if they get dirty. Make sure you hold the tube in place when you change the ribbon. Be sure you can fit 2 fingers under the ribbon to make sure it is not too tight.

When to Call the Doctor

Contact your provider if you have:

• Fever or chills
• Redness, swelling, or pain that is getting worse
• Bleeding or drainage from the hole
• Too much mucus that is hard to suction or cough up
• Cough or shortness of breath, even after you suction your tube
• Nausea or vomiting
• Any new or unusual symptoms

Call 911 or the local emergency number if your tracheostomy tube falls out and you cannot replace it.

Alternative Names

Respiratory failure - tracheostomy care; Ventilator - tracheostomy care; Respiratory insufficiency - tracheostomy care

Greenwood JC, Winters ME. Tracheostomy care. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care . 7th ed. Philadelphia, PA: Elsevier; 2019:chap 7.

Smith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L. Tracheostomy care. In: Smith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L, eds. Clinical Nursing Skills: Basic to Advanced Skills . 9th ed. Hoboken, NJ: Pearson; 2017:chap 30.6.

Patient Instructions

• Mouth and neck radiation - discharge
• Surgical wound care - open

Review Date 7/31/2022

Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Critical Care
• Tracheal Disorders

• Second Opinion

Tracheostomy (Tracheotomy)

What is a tracheostomy?

The term tracheostomy is used to describe a surgically created hole in the neck that extends to the trachea (windpipe) to allow for safe breathing. A tracheostomy tube is the plastic breathing tube that is placed into the hole.

Who needs a tracheostomy?

There are many reasons why a child may need a tracheostomy. Two common reasons include:

• Upper airway obstruction
• The requirement for mechanical ventilation (a breathing machine)

Upper airway obstruction may occur due to bilateral vocal cord paralysis, tracheal or laryngeal stenosis, infection, trauma, or due to a cyst or tumor. A tracheostomy provides an alternative pathway for air to easily bypass the upper airway and  enter the lungs.

Long-term mechanical ventilation may be required as a result of lower airway obstruction (such as bronchomalacia or tracheomalacia) or due to neurologic conditions or chronic lung or heart disease. A tracheostomy allows for a ventilator to be used without a breathing tube that goes through the mouth or nose (endotracheal tube.) For long-term ventilation, a tracheostomy is considered safer and more comfortable than an endotracheal tube.

Is a tracheostomy permanent?

For most children the tracheostomy is not permanent. The length of time it stays in place depends on the individual patient and the reason it was initially placed. Although some tracheostomy tubes stay in place for many months or years, many are temporary and can be removed after a shorter period of time. After the tracheostomy tube is removed, the hole frequently closes by itself. If it does not close by itself, the hole can be surgically closed.

How is a tracheostomy performed?

The tracheostomy procedure is performed in the operating room under general anesthesia. A small incision is made in the skin overlying the trachea in the middle of the neck. The surgeon exposes the airway and makes a small incision into the trachea. The tracheostomy tube is placed in the hole, and secured to the neck.

What can I expect after the tracheostomy?

The tracheostomy tube is changed to a new tube by the surgeon several days after the operation. Occasionally, the ties around the neck are changed during the first week after the operation. After the tracheostomy incision site is noted to be healing well, a tracheostomy care nurse will begin working with the family to learn how to care for a tracheostomy.

What are the effects of tracheostomy?

The specific effects of the tracheostomy tube will  depend on the age of the child, the reason the tracheostomy tube was placed, and the need for long-term ventilation. It is important that you discuss your child’s tracheostomy and the effects of the procedure with your child’s surgeon. When a tracheostomy is present, care must be taken to prevent water or sand from getting into the tracheostomy tube (no swimming.) As a general rule, the tracheostomy tube will not  keep your child from being able to eat normally or use their voice, although some children may not be able to eat orally or speak for other reasons. Many children with a tracheostomy tube are able to lead happy lives.

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Health Library CPR and Rescue Breathing for Adults with Tracheostomy (Ages 12 and older)

How do you perform cpr and rescue breathing on adults with tracheostomy (ages 12 and older), you arrive on the scene: check the scene for safety.

Check the victim for consciousness. Gently tap the shoulder and shout.

No Response

Call 911 immediately.

If the adult is lying on his stomach, turn him over onto his back. They should be lying on a hard flat surface.

Check for Breathing and Signs of Life

Watch their chest for any normal movement. Look for signs of life and breathing for no more than 10 seconds.

No Breathing or Signs of Life

1. Position the heel of one hand on the center of the adult’s chest. Place your other hand on top.

2. With your elbows locked and arms straight, lean over the adult and compress the chest at least two inches in depth 30 times.

3. After the compressions, give breaths using a resuscitation bag attached to the trach. Gently squeeze the bag and give two breaths − just enough to make their chest rise.

4. Continue with 30 compressions / two breaths, 30 compressions / two breaths, etc.

If Breaths do not make chest rise

a. Suction the trach tube. If the trach has an inner cannula, remove it and suction the length of the trach tube.

b. Change the trach if it is plugged or dislodged.

c. Give two breaths to the trach, using a resuscitation bag.

Continue CPR until you see signs of life, another rescuer takes over for you, or help arrives.

Education Opportunities

The Center for Simulation and Research  at Cincinnati Children’s offers CPR classes for patient families. Call 513-636-1096 for more information.

For additional information, call the CPR Department, 513-636-1096 , or your pediatrician.

Last Updated 02/2023

About the Video

The video on this page demonstrates proper techniques when providing rescue breathing and CPR for people ages 12 and older with a tracheostomy. 

BE ADVISED: This is not a certification for CPR. 

Translations

• Spanish Translation
• Arabic Translation - Text
• Arabic Translation - Video

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