Tracheostomy and Ventilator Dependence

People who have breathing problems may have a tracheostomy and may also need help breathing from a mechanical ventilator. Speech-language pathologists, or SLPs, can help people with any speech, communication, and swallowing problems that they have. 

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About Tracheostomy and Mechanical Ventilation

When a person has trouble breathing, they may need surgery to help them. A doctor makes an opening through the front of the neck and into the person’s windpipe, which is also called the trachea. The opening is called a tracheostomy. Air goes in the opening through a metal or plastic tube called a “trach tube,” or “trach,” instead of through the person’s nose or mouth when they breathe. A trach tube might be needed for a short time, might be needed for a long time, or might be permanent. Some people also might need a mechanical ventilator, which is a machine that helps them breathe.

Young children who need a trach do not get to practice talking or making sounds from their mouths without assistance. This lack of practice can cause speech and language delays.

If you have a tracheostomy or need a mechanical ventilator to help you breathe, an SLP will help with any speech, communication, and swallowing trouble you have.

Speech and Swallowing Treatment

If you have a tracheostomy or need a ventilator to help you breathe, an SLP will help with any speech, communication, and swallowing problems. SLPs work with you, your doctor, and/or your respiratory therapist to find and teach you the safest and best way for you to speak.

Trach tubes make it hard to talk in the same way we usually do because air from your lungs goes through the tube in your neck, rather than through your mouth. SLPs can help you learn new ways to talk. You might be able to make your voice work by covering the trach tube opening with your finger, or you may be able to use a speaking valve to help you talk. A speaking valve is a special attachment designed to help you speak with a trach, but not all trachs allow for this attachment. The speaking valve is placed over the trach tube, and it allows air to move in through the neck but not back out. Instead, the air is pushed up through your voice box (larynx) and to your mouth. There are also special speaking valves that you can use with a ventilator.

When you have a tracheostomy, your voice may sound different than it usually does, and it might be quieter than normal.

SLPs can help you find other ways to communicate. You might write, text, point to pictures, or use a computer. These options are known as augmentative and alternative communication, or AAC.

Some people with a trach have a hard time swallowing food and liquids. An SLP can help you eat and drink safely by teaching you different ways to swallow, by doing swallowing exercises with you, by having you eat different types of food, or by teaching you different ways of feeding yourself.

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