After Getting a Tracheostomy: How to Care for Your Child

A tracheostomy (also called a tracheotomy) is a surgically made opening (stoma) in the front of the neck into the trachea (windpipe) to help kids get air to the lungs. A tracheostomy (trach) tube keeps the stoma open so air can get into the lungs. Trach ties hold the tube in place. The word "trach" can refer to the procedure, the opening, or the tube itself.

Your child's care team showed you how to care for your child's trach tube and how to deal with emergencies, such as replacing the tube immediately if it comes out.

• Give your child any prescribed medicine as directed by the health care provider.

• Always wash your hands well before and after caring for your child's trach tube or stoma.

• Clean the opening around the tube as instructed by the care team.

• Follow the schedule outlined by your care team for suctioning the tube, changing the trach ties, and replacing the tube.

• Keep sprays, powders, perfumes, pet hair and sand away from your child's trach tube. 

• Follow your health care provider's instructions for when your child can return to school, child care, active play and other activities.

Your child:

• is in pain

• has warmth, swelling or redness around the stoma

• has a fever 

• has a cough

• has foul-smelling, thick or bloody mucus; a change in color of the mucus; or a lot of mucus in the tube

• needs more oxygen than usual

• has desaturations (drops in oxygen levels) 

• is very tired or seems anxious

• throws up or has trouble with feeding

• The area around the tube is bleeding.

• Your child has any of these signs of dehydration:

  • a dry or sticky mouth

  • peeing less

  • no tears when crying

  • dizziness

  • drowsiness

• The trach tube comes out and you can't replace it.

• Your child has a desaturation that does not improve with the steps you have been taught.

• Your child is not breathing or has trouble breathing.

• Your child's lips or skin look blue or gray.

Who needs a tracheostomy tube? Kids who need to be on a ventilator or who can't breathe through the nose or mouth may need a tracheostomy tube. Trachs can stay in place for a long time.

Can a child with a tracheostomy tube speak? Kids may need to learn new ways to speak with a trach tube in place. Ask your child's health care provider if a speech therapist could help your child speak.