While your child is in the hospital, you will learn how to take care of their trach. Everyone is different, and it can take months to learn the skills and feel comfortable.
You will learn at your own pace. Do not hesitate to ask questions.
Your BEST checklist
For your BEST day with your child, always check the following every day:
- B: Baseline and breathing (and bagger if needed)
- E: Emergency equipment
- S: Suction equipment
- T: Trach ties for tightness and safety
Knowing your child’s baseline
The first thing you will learn is your child’s baseline work of breathing, which is different for every child. You will do this by noticing:
- How much effort it takes your child to breathe.
- How fast your child breathes at rest when they are comfortable.
- The normal colour of your child’s lips, face, and nails.
Recognizing a change in your child’s breathing, behaviour, and appearance can be an early sign that they need medical attention.
Cleaning the stoma
To prevent infections, it is important to check your child’s trach tube and stoma and keep the area clean.
Check the stoma site regularly. Tell your child’s healthcare provider if you see any redness, bleeding, lumps, or mucus coming out.
Clean the stoma 2 times a day. To clean the stoma:
- Prepare 4 clean cotton-tipped applicators or folded gauze moistened with sterile water or normal saline. If there is a lot of oozing around the stoma, you may need extra cotton-tipped applicators to clean it well.
- Use each gauze or cotton-tipped applicator only once, starting at the stoma and moving outward. This pushes germs away from the stoma as you clean it.
- Use 4 clean cotton-tipped applicators or folded gauze to dry the stoma in the same way you cleaned it.
You can put a trach dressing between the trach tube and the skin to reduce rubbing and collect mucus.
Trach tie safety
Your child’s trach tube will be secured to their neck using trach ties. You and your child’s healthcare provider will decide on the type of ties that work best for your child.
Here is what you need to remember about trach tie safety:
- Ensure you can place 1 finger between the trach ties and your child’s neck. If you can fit more than 1 finger, the ties are too loose, and the trach tube is not secure. If the ties are too tight, it could affect blood flow, and your child could become very uncomfortable.
- Changing the trach ties is a 2-person job: 1 person to hold the trach tube in place when the ties are not secure, and 1 person to change the ties.
- Trach ties should be changed once a day or more if they are dirty or wet.
- When you are changing the trach ties, check if your child’s skin looks red or damaged under the ties.
Suctioning
Your tracheostomy educator will teach you how to suction the trach tube regularly to keep it clear.
Normally your child’s mucus will be clear or white and thin. If it changes to yellow or green and becomes thick or has a bad smell, contact your healthcare provider.
Make sure you only suction as deep as your healthcare providers tells you. Going too deep can cause irritation and bleeding.
