In order to manage the client on a mechanical ventilator is it necessary to perform a tracheostomy?

Emergency tracheostomy is necessary if the airway is not accessible (ie, due to swelling or some obstruction in the mouth or throat) and the patient cannot breathe. Otherwise the patient can be orally intubated and attached to the ventilator.

After more than 7 days on the mechanical ventilation, however, it is wise to perform a tracheostomy for longer term management without maintaining the tube down the throat.