Weekend doctor: Intubation vs. Tracheostomy

By Emily Dulgar, RN
Birchaven Village
When you hear a physician say that you or a loved one needs to be intubated or needs a tracheostomy, it is important to understand the purpose of these and how they differ.

A tracheostomy (trach) is a procedure in which a doctor surgically makes an incision in the trachea, sometimes called the “windpipe.” Tracheostomy procedures are performed when there is an obstruction in the airway and intubation is medically not possible, a patient has inefficient oxygen delivery or has problems with secretions.

Once the incision is made, a tube is placed in the windpipe. This tube holds the airway open and allows air to move in and out of the lungs. When a trach is placed, one may be able to breathe without a breathing machine, also known as a ventilator, or a ventilator may be needed.

When a tracheostomy is no longer needed, it can be removed and allowed to heal on its own, or the physician may close it surgically. Patients can be discharged home with a trach; but with that, comes new learning experiences. A trained respiratory therapist or a professional nurse will help you and your family learn to care for the trach.

Intubation (or being intubated) is the process in which a breathing tube is placed into the mouth and down the throat to provide oxygen via a machine. Intubation is done when one cannot maintain their airway on their own due to anesthesia or illness. Often, a person is intubated for a short time, and a person would not go home when they are intubated. Patients cannot be discharged with intubation and must have medical supervision.