Symptom Management
Symptom Management
If your child is having trouble breathing, the trach tube falls out or becomes blocked, and you cannot immediately solve the problem, call 911.Why is this happening?
- Infection
What to do...
- Contact your doctor’s office and report symptoms
- If your child has a fever or an increase in difficulty breathing, contact your doctor immediately
- If breathing becomes severe, call 911
Why is this happening?
- Not enough humidification
- Irritation to respiratory tract from suctioning too vigorously
What to do...
- Increase humidification
- Stay well hydrated
- Assure you are gently suctioning to the appropriate depth
- If it persists or becomes worse, contact your doctor’s office
Why is this happening?
- Irritation and injury to airway
- Active bleeding from a blood vessel
What to do...
- At times, there may be some oozing around trach after a trach tube change. If oozing does not decrease, contact doctor’s office.
- For unexplained bright red or frank bleeding, contact doctor or call 911
Why is this happening?
- Dehydration
- Not enough humidification
What to do...
- If not fluid restricted, increase fluids
- Increase humidification
- If prescribed, give nebulizer to help loosen secretions
- Suction trach
Why is this happening?
- Thickened or dried secretions
- Obstruction by a foreign body
What to do...
- Attempt to suction.
- If little or no improvement, change trach or inner cannula.
- If still little or no improvement, call 911.
- May repeat suctioning.
- If child stops breathing, begin CPR.
What to do...
- Replace trach tube of same size.
- If unable to replace trach tube of same size, attempt to place trach one size smaller.
- If unable to replace, immediately call 911.
What to do...
- Call 911.
- If child is having trouble breathing, give rescue breaths with resuscitation bag with mask covering mouth and nose. (Cover stoma with gauze and tape.)
Why is this happening?
- Possible aspiration
- Fistula
What to do...
- Stop child from eating and drinking, or turn off tube feed immediately.
- Suction trach.
- Contact doctor immediately for instructions.
- If child is having trouble breathing, call 911.
Why is this happening?
- Many possible reasons
What to do...
- If there is a change in breathing and it is not causing immediate distress to the child, call the doctor.
- For severe trouble breathing, high-pitched wheezing, or shortness of breath with or without sweating, fever, agitation, anxiety and/or drowsiness, call 911.
- Be prepared to give rescue breaths or start CPR if child’s condition gets worse.
Why is this happening?
- Irritation
- Possible infection
What to do...
- Increase frequency of skin care, making sure to keep area clean and dry.
- If stoma remains red and is associated with colored drainage or fever, contact the doctor.
Why is this happening?
- Too much movement of the trach tube
What to do...
- Alternate position of ventilator tubing.
- Make sure trach ties are tight enough.
- Call ENT to make them aware. Your child may need a cream for the site.
Why is this happening?
- Leak within system
- Deflated cuff on trach
What to do...
- Check balloon on trach for inflation.
- If leaking or cannot inflate, replace trach.
- Check ventilator tubing.
- If there’s trouble breathing, call 911.
- Be prepared to give rescue breaths or start CPR if child’s condition gets worse.