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    Tracheostomy: What to Expect in the Hospital

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    What is a Tracheostomy?

    A tracheostomy (trach) is a surgical procedure in which a doctor creates an opening (stoma) in the front of your neck into your windpipe. This opening allows air to flow in and out of your lungs. A small curved, plastic tube (tracheostomy tube) is then placed into the stoma. This tube serves as a pathway to make breathing and the clearing of secretions easier, and as a way to keep the stoma open.

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    Your Hospital Stay

    The length of time you stay in the hospital depends upon your medical condition. Your hospital stay will also depend upon how long it takes you or your caregiver to learn how to care for your tracheostomy.
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    Communicating with a Tracheostomy

    Communication is often the biggest challenge after having a tracheostomy. After surgery, the majority of people will breathe through their stoma/tracheostomy tube and not through their nose or mouth. In order to talk, air must pass through the vocal cords (voice box). When air goes in and out through your stoma/tracheostomy tube, it does not go through your vocal cords (voice box), and you will not be able to talk. Sometimes, you can be given a type of tracheostomy tube that allows some air to go through your vocal cords and out your mouth. You will be able to have this kind of tube if you are able to always swallow easily, and/or you do not need to have a tracheostomy tube with the balloon inflated in order to get enough air into your lungs. If you cannot talk right away, you may be able to do so later on.

    If you cannot speak normally after your tracheostomy:

    • We will give you paper, pencils, and/or a dry erase board to help you communicate.

    • You can also use a picture board to point out or spell words to communicate during your hospital stay.

    • As you recover, the nursing staff, speech, and respiratory therapists will work closely with you to find the easiest way for you to communicate. We will try to make it possible for you to speak at least some of the time.
    Note: If you have had a laryngectomy (voice box removed):
    Your doctor and speech therapist will help you test different speaking devices. This usually happens in your doctor’s office several weeks after surgery and after your incision has healed.

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    Planning Your Activity

    Your nurses will help you to get up and sit in a chair or walk after surgery. Moving around helps you recover more quickly. If it is difficult for you to get out of bed, please let the staff know. Ask for help by putting on your call light before you get out of bed.

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    About Your Diet: How to Handle Swallowing Difficulties

    Your ability to swallow food will depend on your medical condition as well as the type of tracheostomy tube you have. Your team (your doctors, nurses, dietitian, respiratory, and speech therapists) will help you make this decision. We will test your ability to swallow with the tracheostomy in place. The dietitian will talk with you about foods you need to eat, or avoid, as well as what you like to eat.

    Some people will not be able to eat at all and they will receive their nutrition through a tube placed in the stomach. In this case, you may be able to have a few bites of food for pleasure, but only if you are able to swallow safely. Discuss this with your doctor, respiratory therapist, and/or speech therapist.

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    Tests & Treatments

    Swallowing Test: A swallowing test may be ordered to see if you are able to swallow safely. This test is usually done by a speech therapist.

    Moisturizing Device: You will need to have a moisturizing device over your tracheostomy tube at all times. Depending on your condition you may have one, or both, of these devices:

    • Trach Collar: This moisturizing device is a special neckpiece that attaches to a tube on the wall with mist and oxygen. Unless you have a portable mist machine, the trach collar can only be used when you are in bed or sitting in one place.

    • Artificial Nose: This moisturizing device allows you to get up out of bed and walk around.

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    Managing Your Pain

    You may experience some discomfort, or you may have pain from another existing medical condition. If you are having pain, it is important to take action to control your pain as soon as the pain starts. Managing pain early and adequately is key in effective pain control. Please let your doctor or nurse know if you are having pain.

    There are more suggestions for treating pain; please ask your nurse.

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    Getting Support from the Medical Team

    Hospitalization can sometimes cause serious problems ranging from concerns about your family, future, housing, finances, insurance, and other emergencies. Your doctors and nurses are available to listen and help you with some of these concerns. They will also make the appropriate referrals to case managers, chaplains, clinical nurse specialists, financial counselors, and/or social workers.

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    Arranging Your Transportation Home

    Ask to meet with a case manager if you need help getting home. A case manager can help you make arrangements. Most insurance companies will not pay for transportation home. Otherwise, you may leave the hospital in a car with a family member or friend.

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    Setting Up Help at Home

    A nurse case manager will meet with you if you need extra help or equipment at home. The case manager will help you find out which services are covered by your insurance plan and, if needed, will help arrange for them.

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    More Ways to Learn

    Visit Our Community Health Resource Center located in the lobby at 2100 Webster Street, San Francisco, (415) 923-3155. Services include classes, and support groups on a variety of health topics.

    Produced by the Center for Patient and Community Education in association with the staff and physicians at California Pacific Medical Center. Last updated: 3/15

    Funded by: a generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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