Removal of a Tracheotomy Tube: A Delicate Process

Published in NJ Heart and Lung News

A tracheotomy (also known as a tracheostomy) is a surgical opening in the neck going into the trachea (windpipe). Tracheotomies allow air to get to the lungs when a person’s airway is compromised. The most common situations requiring a tracheotomy are those in which a person’s airway is blocked by a foreign body or a tumor; where there is a chest wall injury; where there are congenital abnormalities that block the airway; or if the person has a severe respiratory disorder.

Having a tracheotomy is not necessarily a permanent solution; if the patient no longer requires it, the tube is removed in a process known as decannulation.

Decannulation can take place when the following criteria are met:

  • The patient is alert, oriented, and able to follow directions
  • The patient is not dependent on a ventilator
  • The patient does not require excessively frequent suctioning of their secretions

Decannulation must be done with great care. It is only attempted after the patient demonstrates that they can tolerate it. In order to determine the patient’s ability to breathe on their own, the tube is usually downsized, then closed for twelve hours, and then for twenty-four hours. All of this is done under the close supervision of medical staff to ensure the patient experiences no respiratory difficulty at any stage.

After decannulation, patients need to be aware of a variety of warning signs. These include breathlessness, noisy breathing, pain, and signs of infection of the tracheotomy wound.

The best place to attempt decannulation is in a facility that specializes in pulmonary care, such as the NJ Heart and Lung Center, part of the Regency Nursing and Rehabilitation Centers. At the NJ Heart and Lung Center, we create an individualized plan for each patient. This is proven to prevent readmission to the hospital, and to improve independence.  

With the help of the area's leading cardiologists and pulmonologists, we have created a program that:   

  • Reduces hospital readmissions and patient length of stay
  • Maximizes ability for patient to regain ADL skills and independence
  • Offers 24/7/365 physician coverage through on-site staff and advanced telemedicine program
  • Has an on-site sleep study program to unlock Medicare benefit for Bipap utilization upon discharge
  • Offers STAT availability of Labs, X-Ray and other diagnostic tools

Our Outcomes & Capabilities include: 

  • Cardiologist and pulmonologist on site daily for immediate intervention
  • Specialized rehab & nursing protocols developed in partnership with leading cardiologists & pulmonologists
  • A plan proven to prevent readmission to the hospital and improve patient independence and functionality
  • Regular Communication Between Patient, Family, Staff & Physicians
  • Collaborative care planning with other physician & therapy specialists
  • Advanced staff education & training
  • Transitional care nurse & enhanced discharge-to-home process
  • Follow-up home visit within 24-48 hours
  • Educational material provided to patients & families

Regency prides itself on offering the very best of care in a patient-centered environment. This means always listening to our residents and patients and respecting their capabilities, while helping them to achieve maximum functionality and independence. And always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.   Contact us by clicking here.

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Are you interested in The NJ Heart and Lung Center for yourself or someone you love? A member of our team will be happy to answer your questions and schedule an on-site tour. Of course, you can also call us anytime.

The NJ Heart and Lung Center at Regency Jewish Heritage
380 DeMott Lane, Somerset, NJ 08873
(732) 873-2000
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The NJ Heart and Lung Center at Regency Gardens
296 Hamburg Turnpike, Wayne, NJ 07470
(973) 790-5800
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