Tracheostomy Care in Sharjah

What is a tracheostomy?

A tracheostomy is a small opening in the front of the neck, just below the Adam's apple, with a curved plastic tube sitting in it that leads straight into the windpipe. The ventilator, or later an oxygen supply, connects to the end of this tube instead of to a long tube running through the mouth.

Many tracheostomy tubes have a soft cuff, a small balloon near the tip that seals the windpipe so air from the ventilator goes into the lungs. Some also have a removable inner tube that nurses take out and clean, which keeps the airway clear without changing the whole tube.

For your relative, the change is often a relief. With the mouth free of tubes, most people are more comfortable, need less sedation, and can be more awake, move their lips, and take part in their own care. Once the team judges it safe, some people also start to speak.

Who needs it

A tracheostomy is usually suggested when the ICU team expects your relative to need breathing support for a longer spell, or when earlier attempts to come off the ventilator have been slow. The reasons your family may hear include:

• A long, gradual wean after pneumonia or other lung illness, described on the weaning from ventilation page
• Weak breathing or coughing muscles after a long critical illness
• Difficulty clearing phlegm from the chest without help
• Reduced alertness that makes protecting the airway harder
• Swelling or narrowing in the throat above the windpipe

The critical care doctor explains why it is being recommended for your relative and talks it through with the family first. How the ventilator itself supports breathing is covered on the ventilator support page.

What happens

The tracheostomy is placed by the medical team at the bedside or in theatre, with your relative given anaesthetic medicines so they sleep through it and feel no pain. A small dressing sits around the opening afterwards, and the tube is held in place with a soft neck tie.

At Dar Al Kamal Hospital, Sharjah, nurses look after the tracheostomy around the clock:

• Suction gently clears phlegm through the tube, because coughing it up is harder at first
• Humidification warms and moistens the air, a job the nose normally does, so secretions stay thin
• Stoma care keeps the skin around the opening clean and dry, with regular dressing changes
• Inner tube cleaning, where the tube has one, keeps the airway open
• A spare tube and emergency equipment stay at the bedside at all times

As strength returns, ventilator help is reduced in stages. Later, the cuff may be let down for periods and a speaking valve attached, a one-way cap that lets breath flow out past the vocal cords so your relative can talk. Swallowing is checked before food and drink restart, with specialist swallow and speech input arranged by referral where needed.

Preparing for it

Families can help in simple, practical ways:

• Keep one family contact who hears each day's plan and shares it, including with relatives living abroad.
• Bring a list of medicines, allergies and past illnesses, and share any wishes your relative has expressed about treatment.
• Write down your questions, such as why a tracheostomy is advised and what the next step looks like.
• Plan ways to communicate. Before speech returns, a pen and paper, a letter board or a phone with large text help your relative ask for things and feel less isolated.
• Tell the team about religious and cultural needs, including prayer and preferred language, so they are respected.

Visiting arrangements are explained by the unit.

Afterwards

When your relative breathes comfortably, clears phlegm well and copes with the tube capped or the cuff down, the team plans decannulation, the removal of the tube. A dressing covers the opening, which usually closes and heals by itself, leaving a small scar. The voice may sound weak at first and grows stronger with practice.

A small number of people go home with a tracheostomy. That happens only after the family has been fully trained by the treating team, with supplies and a clear plan in place.

If a tracheostomy tube comes out, or seems blocked and your relative struggles to breathe, call for help immediately, using the nurse call or emergency alarm in hospital, or emergency services at home. Contact the hospital on 06 599 7777 with any other concern, such as redness or discharge around the healed opening.

Cost and insurance

Tracheostomy care forms part of the intensive care stay, which most UAE insurance plans cover with notification and continuing approval. Placing the tube may need its own pre-approval, which the hospital requests from the insurer. The insurance office at Dar Al Kamal Hospital, Sharjah can guide your family on 06 599 7777.