What Is the Difference between a Tracheostomy and Intubation?

C. Webb

The tracheostomy and intubation are medically used methods to assist a patient in breathing. The primary difference between a tracheostomy and intubation is that a tracheostomy is a surgical procedure to create opening into the trachea for long term protection of airway and can be continued following discharge from the hospital, while intubation is for short term protection and typically requires continuous monitoring in the intensive care unit. In addition, intubation does not usually require any incisions, while a tracheostomy uses a surgical incision in the throat to be put in place. Several factors, including patient age, medical issues, and throat structure, are considered when deciding whether to use a tracheostomy or intubation to help the patient breathe.

A sore throat is common following an intubation procedure.
A sore throat is common following an intubation procedure.

A tracheostomy differs from intubation in that a tracheostomy requires a surgical procedure to complete. An airway is cut into the patient's cervical trachea, which is located at the base of the front of the neck. Once the hole is cut, a medical device called a stoma is placed in the hole. A stoma is an inflexible tubular-shaped piece that holds the surgically cut airway open and allows air to pass through into the lungs.

Intubation usually doesn't require an incision.
Intubation usually doesn't require an incision.

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Intubation does not require surgical openings to be used. It works by running a thin, flexible tube through the mouth, down the throat, and into the lungs. Once in place, the tube remains there until the attending physician orders it removed. Through this tube, air is provided by a machine connected to a monitoring device. Health-care workers are able to set the machine to deliver as many breaths per minutes as the patient would normally breathe on his or her own.

A horse voice is common after the removal of intubation.
A horse voice is common after the removal of intubation.

Patients with tracheostomies can breathe on their own, or the breathing can be done for them by attaching a tube to the tracheostomy opening and having the air pumped to and from the lungs by machine. An important difference between a tracheostomy and intubation is that with intubation, the patient does not breathe completely on his or her own, but instead has regulated assistance from the machine. Breathing can be done entirely by machine,or the machine can be adjusted to allow the patient to breathe with assistance. For example, the patient contributes 25 percent to each breath, and the machine contributes 75 percent.

A tracheostomy is a surgical procedure to create an opening into the trachea.
A tracheostomy is a surgical procedure to create an opening into the trachea.

Tracheostomies are typically used when an upper airway obstruction makes intubation difficult or impossible. Obstructions can be caused by structural defects in the neck or throat, tumors, swelling, or injury. The tracheostomy is cut below the upper airway, bypassing the obstruction interfering with breathing.

A tracheostomy requires cutting a hole in the windpipe.
A tracheostomy requires cutting a hole in the windpipe.

Healing time is another difference between a tracheostomy and intubation. The procedure for removing intubation is to require the patient take in a deep breath and forcefully exhale while medical workers pull the tubing out. Once it is removed, though the patient may be sore and hoarse, no additional healing is needed. Tracheostomies are removed through a surgical procedure. After the stoma is out, the skin will close the hole in approximately one week, though a visible scar may remain for life.

Patients who are pregnant may experience difficulties during the intubation process.
Patients who are pregnant may experience difficulties during the intubation process.
The trachea is the tube that connects the nose and mouth to the lungs.
The trachea is the tube that connects the nose and mouth to the lungs.
Paramedics may be required to perform a tracheostomy in the field.
Paramedics may be required to perform a tracheostomy in the field.

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