How to Change a Tracheostomy Tube
Procedure/Treatment/Home Care
Si usted desea esta información en español,
por favor pídasela a su enfermero o doctor.
#1071
Name of Child: ______________________________ Date: _________________
How to Change a Tracheostomy Tube
The doctor will tell you when to change your child’s tracheostomy tube.
You will also need to change the trach tube when:
• Mucous builds up, and it cannot be suctioned out
• The trach tube comes out by accident
• Your child has trouble breathing, and suctioning does not help
• Your child is not breathing
What you need:
p New or cleaned trach tube of the same size
p New or cleaned trach tube one size smaller
p Shoulder Roll
p Lubricating Jelly (not petroleum jelly)
p Trach ties (cut to neck size)
p Suction machine and suction supplies
p Gauze pad with a slit (if needed)
p Another person to help you
p Ambu bag
outer cannula
wings
trach tube
obturator
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trach tube with
obturator in
What to do:
1. If needed, suction your child’s trach.
2. Put the blanket roll under your child’s shoulders. If necessary, wrap your child in a blanket (swaddle).
3. If trach has a cuff, deflate the cuff.
4. Open new or cleaned trach tube, insert obturator.
5. Lubricate trach tube, if it will make it easier for you.
6. Have another person hold the trach in place, and take off the trach ties.
7. If your child uses a ventilator, you may need to use the ambu bag.
8. Remove the trach tube from the stoma.
9. Follow the curve and gently put the new trach tube into the stoma.
10. While holding wings of the trach, remove the obturator right away.
11. If your child’s trach has a cuff, inflate it.
12. Clean the trach tube site and neck.
13. Place the gauze pad under the flanges of the tracheostomy tube, if needed.
14. Replace tracheostomy ties. Make sure you can only slide one finger between the
trach ties and your child’s neck. This is done to be sure the ties are tight enough
so the trach tube can’t fall out by accident, but not too tight.
15. Make sure your child is breathing easily. Suction if needed.
If the trach tube is not going in:
1. If you have trouble putting in the tracheostomy tube, change your child’s position and try to put it in again.
2. If you still have trouble, try to put in the smaller size trach tube.
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3. If you still can’t put in the trach tube, put a suction catheter into the opening. Hold it in place and call 911. Begin CPR if necessary. Ask your nurse or doctor for
the Trach CPR handout that matches your child’s age and weight:
• CPR for an infant with a tracheostomy #399
• CPR for a child with a tracheostomy #400
• CPR for a person over 70 pounds with a tracheostomy #708
Now that you’ve read this:
p Tell your nurse or doctor what supplies you need to change a trach tube, and what each is for. (Check when done.)
p Show your nurse or doctor how you would change a trach tube.
(Check when done).
p Tell your nurse or doctor what you would do if you had trouble putting the trach tube in. (Check when done).
If you have any questions or concerns,
p call your child’s doctor or p call ______________________
If you want to know more about child health and illness,
visit our library at The Emily Center at Phoenix Children’s Hospital
1919 East Thomas Road
Phoenix, AZ 85016
602-933-1400
866-933-6459
www.phoenixchildrens.com
Facebook: facebook.com/theemilycenter
Twitter: @emilycenter
Pinterest: pinterest.com/emilycenter
Disclaimer
The information provided at this site is intended to be general information, and is provided for educational purposes only. It is
not intended to take the place of examination, treatment, or consultation with a physician. Phoenix Children’s Hospital urges
you to contact your physician with any questions you may have about a medical condition.
Tuesday April 8, 2014 • DRAFT to family review
#1071 • Written by Kristen Meliska, BSN, RN • Illustrated by Dennis Swain
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Si usted desea esta información en español,
por favor pídasela a su enfermero o doctor.
#1071
How to Change a Tracheostomy Tube
Name of Health Care Provider: _______________________________
Date returned: ____________ p db
Family Review of Handout
Health care providers: Please teach families with this handout.
Families: Please let us know what you think of this handout.
Would you say this handout is hard to read? p Yes p No
easy to read? p Yes p No
Please circle the parts of the handout that were hard to understand.
Would you say this handout is interesting to read?
p Yes p No
Would you do anything differently after reading
this handout?
p Yes p No
Why or why not?
If yes, what?
After reading this handout, do you have any
questions about the subject?
p Yes If yes, what?
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p No
Is there anything you don’t like about the drawings?
p Yes If yes, what?
What changes would you make in this handout to make it better or
easier to understand?
Please return your review of this handout to your nurse or doctor
or send it to the address below.
The Emily Center602-933-1395
Health Education Specialist
Phoenix Children’s Hospital
1919 East Thomas Road
Phoenix, AZ 85016-7710
Thank you for helping us!
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p No