Generally, if your child needs a trach, it is not something you can go home, think about, and return to the doctor with your answer. Most cases don’t allow you the gift of that choice. If you do have the liberty of that option, it’s not likely you have much time to think about your decision.
Don’t panic and don’t get all upset! Having a trach is not the end of the world. You do need to consider if it will be the end of the world if you decide not to give permission. Keep in mind why the procedure is essential!
There are a group of reasons why a tracheostomy should be performed. A tracheotomy is a surgical procedure that is regularly done in the operating room. An incision is made into the trachea, or windpipe, which forms a permanent or temporary opening called a tracheostomy. Both terms, tracheotomy and tracheostomy, are used interchangeably.
Some reasons in which a tracheostomy is needed or performed are as follows:
1. To maintain a stable airway due to a traumatic injury, burns, tumors, vocal cord paralysis, foreign bodies, surgical edema, and any other airway obstructions.
2. To prevent aspiration of gastric contents.
3. Lung and airway anomalies secondary to congenital defect
4. To allow long-term, positive pressure ventilation due to neuromuscular disease, respiratory failure, spinal cord injury, or massive chest wall trauma.
5. To ease the elimination of secretions caused by neuromuscular disease, severe bronchitis in a debilitated patient, and paralysis of chest muscles and diaphragm.
6. To increase the capacity and volume entering the lungs and decrease the work of breathing by reducing anatomical dead space (severe COPD).
7. To improve comfort due to the absence of ET (endotracheal tube).
Whatever the reason or reasons, I’m sure your child’s doctor has some very good reasons at to why he feels this course of action is crucial.
My oldest son, Greyde, required a trach before he was even two months old. His macroglossia, enlarged tongue, caused extreme apnea while he slept, and he definitely could not lie on his back. Shortly after his first tongue reduction surgery, the trach came out. I was relieved to see it go, and yet, I found comfort in having it knowing his airway was secure.
It can be overwhelming to think about your child having a trach. I remember thinking and feeling it was almost the end of the world. It’s terrifying to imagine your child needing assistance to breathe! It definitely does not mean your child has to quit being a child. Greyde was absolute proof of that!
Nothing has to stop them from changing their usual play routine although, like most things, certain precautions and measures should be taken. Your child’s ENT and/or surgeon, other physicians involved, and the hospital will educate you and answer all your questions and concerns regarding trach care before you take your munchkin home.
Children and adults go home with tracheostomies more than you might think. It’s up to you as the parent/caregiver to learn all you can about how to help keep your child’s airway safe and clean.
Please check back as I will be adding articles for suctioning, trach care, and cleaning your equipment.
Take care, and I hope you and yours are well.
