Your tracheostomy educator and the family education program will teach you the skills you need to handle trach emergencies.

It’s important to know how your child normally breathes, looks, and behaves (their baseline) so you can recognize problems right away. You also need to be trained in suctioning, tracheostomy tube changing, and CPR.

Recognizing emergencies

You may suspect your child’s trach tube has a problem if their baseline has changed. For example, you notice they are breathing faster, are working hard to breathe, or their colour changes.

Call 911 right away, and follow the emergency procedures you learned at the hospital, if you child has any of these problems:

• The trach tube is blocked. Mucus can build up and form a thick, crusted layer inside the trach tube.
• The trach tube comes out. You can see the end of the tube is no longer in your child’s stoma. This is called decannulation.
• The trach tube comes out part way. It looks like it is in the stoma, but it is not sitting properly in the windpipe, and your child is having trouble breathing.

Other trach problems may not be emergencies, but you still need to report them to your child’s healthcare team right away:

• Your child is having a harder time breathing even with suctioning, and they don’t need a trach change.
• You see a little bleeding in or around your child's trach or stoma.
• You think your child has an infection. Signs may include fever or change in mucus (yellow or greenish colour, thick and sticky, strange smell).

Calling 911

Always have a working landline or fully charged cellphone with you. You may have to call 911 in an emergency. If you do, tell the 911 operator:

• If your child is alert and breathing or not.
• Your child is having an airway emergency and breathes through a trach tube.
• If you have changed or are changing the trach tube.
• If your child is still having trouble breathing after the trach tube change.
• Any special instructions from your healthcare team about managing your child’s airway.

Emergency supplies

You must always have emergency supplies and equipment nearby. Keep everything together as a kit so you can find things quickly in an emergency.

Always have an emergency kit that includes the following items:

Items in a tracheostomy emergency kit.
Credit: Alberta Health Services

• bagger with connector and mask (if needed)
• obturator from current tracheostomy tube
• 2 extra tracheostomy tubes—1 the size your child uses and 1 a size smaller
• prepared trach ties
• 2 suction catheters
• sterile normal saline syringes
• scissors and tweezers or forceps
• water soluble lubricant
• hand sanitizer and disposable gloves
• barrier device
• manual suction

Always have the following items near your emergency kit:

• fully charged suction machine, charger, and suction supplies, including:
• canisters
• alcohol swabs
• tubing, water
• cups for rinsing catheters
  
• tracheostomy dressings
• cotton-tipped applicators
• heat moisture exchanger (HME)
• paper copies of your child’s trach information and emergency instructions
• contact information for your child’s healthcare team, emergency services, and family members
• a working landline or fully charged cellphone

If your child is on a ventilator, keep the following items with your emergency kit:

• ventilator charger
• spare circuits and spare connectors
• spare filters
• spare exhalation valve
• ventilator settings (written down)
• contact information for Provincial Integrated Respiratory Services
• bagger with mask and connector
• humidifier supplies
• spare inline circuit for the HME
• second ventilator with spare parts and equipment

If your child is on oxygen, keep extra oxygen supplies—such as tubing and connectors—with your emergency kit.​​​​