“เจาะคอ” หัตถการพลิกวิกฤต เพื่อช่วยชีวิตคนไข้

Often we see news in newspapers about patients&#8217; relatives being dissatisfied with doctors performing a tracheostomy because they feel it is a dangerous procedure that might put their loved ones at greater risk. However, in reality, “tracheostomy” is one of the important procedures performed to save a patient&#8217;s life, giving them a chance to survive, be safe, and recover as normally as possible. Therefore, to help everyone better understand this seemingly frightening procedure, today we will introduce what a tracheostomy is and how important it is for patients.
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<h2 style="color: #008080">What is a “tracheostomy” and why is it necessary?</h2>
A tracheostomy is the opening of the upper airway in patients who have an obstruction in the upper respiratory tract, making it impossible to breathe through the nose or mouth. Doctors then relocate the breathing passage to the trachea below the larynx instead. This procedure helps patients breathe more easily, facilitates clearing of sputum, and reduces the risk of scarring in the larynx more than using a ventilator.
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<h2 style="color: #008080">In what cases is treatment with a tracheostomy required?</h2>
A tracheostomy is performed on patients who have an obstruction in the airway caused by a mass or certain conditions, preventing them from breathing on their own, whether acute or chronic, such as tumors or swallowing something stuck in the throat. It is also considered when the patient&#8217;s larynx is non-functional, such as bilateral vocal cord paralysis, severe infection causing laryngeal swelling, or trauma causing bleeding or fractures in the larynx that block the airway, making it impossible for the patient to breathe independently. In these cases, a tracheostomy is necessary to help the patient breathe more easily.
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Additionally, tracheostomy is often performed on bedridden patients who require prolonged intubation for more than 1-2 weeks. Prolonged intubation can cause scarring in the larynx or below the vocal cords, making it difficult for patients to breathe after recovery due to obstruction caused by the scar tissue.
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<h2 style="color: #008080">How is a “tracheostomy” better than “intubation”?</h2>
Generally, doctors consider tracheostomy only in emergency and necessary cases, except for patients who need intubation for more than 2 weeks. In such cases, doctors consider tracheostomy to reduce risks. Tracheostomy benefits patients in several ways, such as:
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<li>Tracheostomy allows better clearance of sputum than intubation, reducing the risk of infection more effectively.</li>
<li>It helps reduce the occurrence of scarring below the vocal cords, allowing patients to breathe fully after recovery.</li>
<li>Tracheostomy causes less trauma to organs compared to oral intubation because the tube insertion path is shorter and does not pass through the mouth, throat, and larynx.</li>
<li>Tracheostomy tubes are easier to manage and less likely to dislodge because they are secured with a neck strap, preventing tube displacement regardless of patient movement. In contrast, oral intubation tubes are secured with tape or strings, which can easily come loose and cause danger.</li>
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<h2 style="color: #008080">Tracheostomy is a life-saving procedure&#8230; both planned and emergency cases</h2>
Tracheostomy is a surgical procedure performed in an operating room under general anesthesia, requiring an incision. Therefore, relatives must be informed and give consent, or if the patient is conscious, consent must be obtained from the patient before the procedure. However, there are exceptions in very emergency cases, such as accidents where oral intubation is not possible, patients with laryngeal tumors, or any condition that prevents the patient from breathing independently and oral intubation is not feasible.
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All these cases require tracheostomy to save the patient&#8217;s life and allow treatment to continue. This means that before doctors decide to perform a tracheostomy on any patient, they have carefully considered the necessity and priority, concluding that the tracheostomy is essential; otherwise, the patient could face life-threatening risks.
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<h2 style="color: #008080">Are there any dangers or risks when a patient undergoes a tracheostomy?</h2>
Since tracheostomy is a type of surgery, there are potential risks, including bleeding. The area for the tracheostomy is located on the trachea below the larynx, at the level of the second and third tracheal rings, where the thyroid glands and major arteries are nearby. Therefore, the doctor performing the tracheostomy must be highly skilled and cautious to avoid complications.
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<h2 style="color: #008080">How to care for a patient after a tracheostomy?</h2>
Usually, during the first 7 days after a tracheostomy, doctors closely monitor the patient to ensure proper healing of the wound. This period is critical because “the tube can easily become dislodged”. Careful cleaning and suctioning of sputum are necessary to prevent blood from the wound from accumulating in the tube. After monitoring, patients with tracheostomies can usually be discharged home. Generally, tracheostomy is performed for “patients who need ventilators to live at home” because it is easier to manage and reduces the risk of tube displacement.
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Although tracheostomy may seem like a frightening procedure that causes concern among relatives or close ones, in reality, it is a “crucial life-saving step” that enables patients to breathe. It is a safe procedure that reduces risks and adverse effects on the body more than prolonged use of ventilators. Therefore, you can be confident that when doctors decide a tracheostomy is necessary, it is the best option to save the patient’s life, giving your loved ones a chance to recover and live happily with you again.

"Tracheostomy" is one of the treatments to increase the chances of patient survival. But if the patient does not want a tracheostomy, are there other procedures or treatments that can help? We have the answer!

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"Tracheostomy" A life-saving procedure to turn a crisis around

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