Troubleshooting Tracheostomies

Troubleshooting Tracheostomies

Neuro: Anxiety, restlessness
Resp: Respiratory distress, gasping, airway obstruction
CV:Tachycardia, hypertension
Skin: Cool, pale, cyanotic, diaphoretic
Note: Pt may be asymptomatic (with established stomas)

Tracheostomy Dislodgement
■ If tracheostomy is less than 4 days old, STAT intervention is required
because tract can collapse suddenly.
■ Notify physician and RT STAT. Only trained personnel should replace
new tracheostomy tube.
■ Open tracheostomy with a sterile hemostat, suction catheter, or sterile
gloved finger to maintain airway and to keep the edges of the
tracheostomy from collapsing.
■ If Pt cannot breathe, ventilate using BVM.

■ If you cannot be sure that someone clinically prepared to reinsert
tracheostomy tube will arrive within 1 minute, call Code.
■ If tracheostomy is more than 4 days old, tract will be well formed and will
not close quickly.
■ Notify physician and RT that tube needs to be replaced.
■ Obtain replacement tube, if not already at Pt’s bedside.
■ Stay with Pt and prepare for insertion of new tube.