Your Child's Tracheostomy: Care Instructions

Your Care Instructions

A tracheostomy is a surgical opening through the neck into the windpipe (trachea). The opening is also called a stoma. A tracheostomy helps your child breathe if he or she has a lung or nerve problem, an infection, or trouble handling secretions.

Taking good care of a tracheostomy is very important. It can prevent infections and help keep your child breathing easily.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

General tips

Your doctor or nurse will give you instructions about how to take care of your child's tracheostomy, or "trach" (say "trayk"). This will include how to suction your child's trach, and how to clean the opening in the neck (stoma). Be sure to follow all of these instructions closely.

  • Always have your emergency supplies ready and available wherever your child is.
  • Always wash your hands before and after caring for your child's tracheostomy.
  • Keep the air in your home moist with a room humidifier.
  • Have your child eat while sitting up. If any food gets into the tube, suction it out right away.
  • Dress your child in clothes that do not cover the trach and are loose around the neck.
  • Bathe your child sitting up in shallow water. Avoid getting water into the tracheostomy. An older child can shower with his or her back to the water.
  • Replace the ties if they get wet or damaged. If they are not damaged, they can be washed and dried and used again.
  • Your child's trach has two parts: the outer cannula and the obturator, which is used to help insert the trach tube. Do not remove the outer cannula.

Suctioning

Suction your child's trach as you have been trained by your health care team.

  • It is very important to measure and insert the suction catheter as you have been trained by your health care team every time you suction.
  • Suction the trach 3 or 4 times a day, or more if needed. It may be a good idea to suction your child's trach before your child goes to bed and when he or she wakes up in the morning.

Trach care

Trach care includes cleaning and drying the stoma, checking the skin and neck, keeping the tube open and safe, and making sure the ties are clean and fit well. Care for your child's trach as you have been trained by your health care team. Perform the trach care two times a day or more often, if needed.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child has severe trouble breathing, and coughing or suctioning does not help.
  • The trach falls out, and you cannot get it back in, or it is blocked.

Call your doctor now or seek immediate medical care if:

  • Your child has trouble breathing after suctioning.
  • Your child has signs of infection, such as:
    • Increased pain, swelling, warmth, or redness in the stoma.
    • Red streaks leading from the stoma.
    • Pus draining from the stoma.
    • A fever.
  • Your child's secretions change.

Watch closely for changes in your child's health, and be sure to contact your doctor if your child has any problems. Make sure you have your child's emergency supplies, including the obturator, available when help arrives or when you arrive at the doctor's office.