Tracheostomy: What to do in an emergencyTTracheostomy: What to do in an emergencyTracheostomy: What to do in an emergencyEnglishRespiratoryChild (0-12 years);Teen (13-18 years)TracheaTracheaNon-drug treatmentCaregivers Adult (19+)NA2017-08-09T04:00:00ZTiffany Yam, RN;Laura Slingerland, RN;Reshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Evan Propst, MD, FRCSC, MSc;Sara McEwan, RN, MN8.0000000000000063.0000000000000835.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to identify and respond to the signs of respiratory distress if there is a blockage in your child's tracheostomy tube.</p> <p>Many children with tracheostomies use the tracheostomy tube as their main airway. If the tube becomes obstructed (blocked) or dislodged, it is important to know how to respond safely and quickly.</p> <h2>How can a tracheostomy tube become blocked?</h2> <p>Blockages can happen when:</p> <ul> <li>secretions from your child’s lungs become thick and form a mucus plug</li> <li>a foreign body gets stuck in the tube</li> <li>the tube itself is kinked or in the wrong position.<br></li> </ul> <p><strong>A blocked tube is an emergency and can lead to respiratory distress (severe breathing difficulties) if it is not cleared quickly.</strong></p><h2>Key points</h2> <ul> <li>Early signs of respiratory distress (breathing difficulties) include coughing, anxiety and whistling or other new noises from the tube.</li> <li>Late signs of respiratory distress include retractions, pale or blue skin around the eyes and mouth and rattling on your child's chest or back.</li> <li>If there is a problem with your child's tracheostomy tube, check your child's breathing, try to suction the tube and then call 911.</li> <li>When leaving the home with your child, even for a short time, always take all necessary equipment and supplies in a medical travel bag.</li> </ul><h2>What should I do if there is a problem with my child’s tracheostomy tube?</h2> <p>There are three main steps to follow. Please do them in order.</p> <h3>1. Do a quick check</h3> <ul> <li>Check if your child is awake and responds to your voice or your touch. </li> <ul><li>Look: Is the chest rising and falling?</li> <li>Listen: Can you hear breathing sounds from your child’s tracheostomy tube, nose or mouth?</li> <li>Feel: Can you feel air moving from the tracheostomy tube, nose or mouth?</li></ul> </ul> <h3>2. Try to suction the tracheostomy tube</h3> <ul> <li>Extend your child’s neck to open the airway.</li> <li><a href="/Article?contentid=2469&language=English">Suction the tracheostomy tube</a> to the depth you were shown during training. If you cannot insert the suction catheter into the tracheostomy tube, change the inner cannula if there is one. If there is no inner cannula, <a href="/Article?contentid=2467&language=English">change the tracheostomy tube</a>.</li> <li>After suctioning, if the tube is still blocked, change the tracheostomy tube. If you cannot put the tracheostomy tube back in, try placing the half size smaller tracheostomy tube.</li> </ul> <h3>3. Call 911</h3> <ul> <li>Call 911 if your child still shows signs of respiratory distress after suctioning and changing the tracheostomy tube.</li> <li>If you are unable to insert the new tracheostomy tube or the half size smaller tracheostomy tube, ask someone to call 911 while you block the stoma with your finger and start mouth-to-mouth resuscitation.</li> </ul>



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