Tracheostomy Care: Warning Signs

Warning Signs of a Blocked Tracheostomy

There are warning signs that a child with a tracheostomy is having serious trouble breathing. They are:

• Your child is unusually anxious and has a frightened look.
• Your child is restless.
• Your child has trouble eating.
• Your child is breathing rapidly.
• You hear a wheezing sound.
• The nostrils flair with each breath.
• The mouth, lips, or fingernails are pale bluish or dusky.
• The hollow in the neck, the skin between the ribs and the skin under the breastbone may pull inwards with each breath.

If you see any of these signs, immediately suction the trach tube. If the signs continue, change the trach tube and suction again.

If the signs still persist after changing the tube call 911 right away.

Warning Signs of Infection

Look carefully at secretions in the catheter for signs of infection. Call the ENT or pulmonary specialist in charge of your child’s care if:

• The secretions are yellow or green, or if they have an unusual or bad smell. (The first 1 or 2 hours in the morning, the secretions may be yellowish, but they should soon become a clear or white color.)
• You see bright red blood in the secretions. (A few streaks of blood or faint pinkish tinge in the catheter may be normal following a trach tube change.)
• Your child has a fever or is vomiting.

Warning Signs of Dehydration

Make sure your child has enough to drink each day so that secretions remain thin and do not block the trach tube. Your child will need to drink extra fluids when he or she is sick.

Signs that your child may not be getting enough fluids include:

• Your child has stopped wetting his diapers or is wetting a lot less.
• Your child goes to the bathroom less than 3 times a day.
• You notice a change in the color and smell of the urine. A darker color and strong ammonia smell are signs of dehydration.