Tracheotomy in the Life Care Plan

Tracheotomy is utilized for airway access and/or the need for prolonged mechanical ventilation and are a common life care plan component.  A tracheotomy is the creation of an opening in the tracheal wall. A Tracheostomy is a permanent opening created by suturing the trachea to the skin.

A tracheotomy tube, usually made of plastic creates a connection between the airway and air supply.  Tubes come in a variety of materials, shapes and sizes, with and without cuffs, and have the ability to be connected to ventilator circuits.

A suction machine is indicated in the postoperative period, and instructions on how to the tube in the event of blockage is indicated thereafter.

When the underlying medical condition has been resolved, the patient may be evaluated for decannulation (removal of the tube). The patient should be able to breathe comfortably and should demonstrate the ability to manage and clear secretions.

Proper care for a tracheotomy reduces complications and is an essential component of in the life care plan. Complications include infection, tube obstruction and decannulation (accidental removal of the tube).

Indications for Tracheotomy in the Life Care Plan

A patient may require a tracheostomy due to –

  • Airway obstruction
  • Birth injury resulting in neurological compromise
  • Prolonged mechanical ventilation
  • Depressed mental status (inability to protect airway)
  • Surgical access
  • Epiglottitis/supraglottitis
  • Respiratory disease
  • Neuromuscular disease
  • Bilateral vocal cord paralysis
  • Angioedema
  • Foreign body
  • Blunt/penetrating neck trauma

Tracheostomy Education in the Life Care Plan

The patient and/or the patient's caregivers should be provided education regarding tracheotomy prior to and after surgery. Prior to discharge, patients and caregivers should be assessed for competency in care for the tracheostomy and emergency procedures. Caregivers should be able to identify signs of respiratory distress, and both patients and care providers should be able to demonstrate suctioning and cleaning of the tube, tracheostomy change, and the use of all home equipment.Patients should be provided contact information for health care providers and equipment supply companies. and written instruction manual should be provided prior to discharge. 

Pediatric Life Care Plans by a Certified Pediatrician