If a doctor has recommended a tracheostomy for you or someone you love in intensive care, it can raise a lot of questions. This page gives a plain-language introduction – it complements, but does not replace, advice from the clinical team looking after you or your relative.
What is a tracheostomy?
A tracheostomy is a small opening made in the front of the neck and into the windpipe (trachea), just below the voice box. A short tube is placed through this opening to help someone breathe. It is a common and well-established procedure in intensive care, usually carried out when a patient needs breathing support, or help clearing their airway, for a longer period of time.
Illustration: the airway from the nose and mouth to the lungs, with a tracheostomy tube in place below the voice box.
Why might someone need one in intensive care?
Longer-term breathing support
Some patients need help from a breathing machine (ventilator) for an extended period, and a tracheostomy is often more comfortable and safer than a tube through the mouth for this.
Protecting the airway
It can help keep the airway open and protected in patients who are not able to manage this on their own for a period of time.
Clearing secretions
It can make it easier for the care team to clear mucus and secretions from the lungs, reducing the risk of infection.
Weaning from the ventilator
For some patients, a tracheostomy can make it easier to gradually reduce breathing machine support over time.
Possible benefits
Often more comfortable
Usually more comfortable than a breathing tube through the mouth, especially over a longer stay.
May allow speech
Depending on the type of tube used and once medically ready, some patients are able to talk.
Can support weaning
May help some patients gradually reduce breathing machine support as they recover.
Easier day-to-day care
Can make mouth, airway and general nursing care more comfortable for the patient.
Possible risks
Bleeding
There is a small risk of bleeding during or shortly after the procedure.
Infection
As with any procedure, there is a risk of infection at the site or in the airway.
Tube blockage or displacement
The tube can occasionally become blocked or move out of place, which needs prompt attention from the care team.
Scarring and voice changes
A small scar usually remains after the tube is removed and the site heals. Some patients notice temporary changes to their voice.
This is general information and not a complete list – not every risk applies to every patient. Your care team can explain what is most relevant to your, or your loved one’s, individual situation.
About the ON TRACH study and your data
ON TRACH is an observational study. That means it records information about the tracheostomy care that patients already receive as part of their usual treatment – it does not change or influence the clinical care given to you or your loved one.
Information gathered as part of the patient’s routine clinical care will be recorded in a coded format as part of the study and uploaded into a secure electronic database, RedCAP, managed by the Royal College of Surgeons Ireland. No information that could identify the patient will leave the hospital. The information will be held securely and analysed for the purposes of the study. Once the study is complete, the data will be made anonymous and may be used for future research projects related to care of the patient with a tracheostomy in the future, after ethical approval.
A link to the study patient and relative information leaflets will be made available once they have been finalised and received approval.
If you have any questions about the study or how information is used, please contact the study team.
Questions about your, or your loved one’s, care?
The doctors and nurses looking after you or your relative are best placed to explain why a tracheostomy has been recommended, and to talk through the risks and benefits for your specific situation. Please don’t hesitate to ask them.