Home Tracheostomy Care Guide for Children

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Disclaimer: This guide is for informational purposes only and should not replace professional medical advice or training. Always consult healthcare professionals for medical decisions.

Introduction to Tracheostomy Care at Home

Embarking on the journey of providing at-home care for your child’s tracheostomy can be emotionally complex. This guide is designed to assist you in this process. Feel encouraged to express your emotions and ask questions to the healthcare team involved in your child’s care.

Preparatory Steps Before Leaving the Hospital

Prior to your discharge, you will engage in hands-on practice of the necessary care procedures under a nurse’s supervision. This resource aims to address common questions and prompt further inquiries. Do not hesitate to seek clarifications on any confusing aspects.

Understanding Normal Breathing

Normal breathing involves effortless inhalation through the nose, with air being humidified and warmed as it travels to the lungs. Oxygen is then transferred from the lungs to the bloodstream.

About Tracheostomy

A tracheostomy involves creating an opening in the trachea (windpipe) through the neck. Post-healing, this opening is referred to as a stoma, maintained by a tracheostomy tube.

Types of Tracheostomy Tubes:

  • Plastic trach tubes (Shiley)
  • Silicone trach tubes (Bivona)

Differences Between Hospital and Home Care

In the hospital, sterile techniques are used, while at home, you’ll adopt clean techniques due to fewer germs in the home environment.

Sterile Technique:

Clean Technique:

  • Hand washing
  • Optional gloves
  • Reusable, cleaned trach tubes and ties

Tracheostomy Skin Care

The skin around the trach needs regular cleaning to prevent irritation. The process involves using mild soap, water, clean washcloths, and trach ties. Follow a gentle cleaning method, keeping the area dry.

Changing Trach Ties

Customize the trach ties to fit your child comfortably, ensuring they are neither too tight nor too loose. You may use a dry gauze dressing if there are excessive secretions.

Suctioning the Tracheostomy

Suctioning is vital for removing mucus, which can’t be expelled normally due to the tracheostomy. Be observant of signs that indicate the need for suctioning, such as visible mucus, respiratory distress, or changes in skin color.

Suctioning Steps:

  • Proper hand hygiene
  • Preparation of sterile suction catheter kit
  • Measured and gentle catheter insertion
  • Timely removal of the catheter to allow breathing

Changing the Tracheostomy Tube

This process should be calm and unhurried, ideally when your child is at ease.

Supplies Needed:

  • Sterile (or clean) trach tube with obturator
  • Various necessary cleaning and lubricating supplies

Procedure Steps:

  • Clean hands and set up the area
  • Comfortably position your child
  • Replace the trach tube, ensuring it’s secured properly

Cleaning and Sanitizing Trach Tubes

Clean reusable trach tubes using appropriate methods for either plastic or silicone types, ensuring they are free from damage and thoroughly dry before storage.

Emergency Care Guidance

Be prepared for emergency situations like breathing difficulties, dislodged trach tubes, or unsuccessful trach tube insertions. Understand CPR basics and have emergency contact procedures in place.

Daily Life with a Tracheostomy

Adapt your child’s bathing, dressing, play, and sleep routines to accommodate the trach safely.


Providing tracheostomy care at home requires knowledge, practice, and confidence. Utilize this guide as a reference and always stay in close contact with your child’s healthcare team for guidance and support.

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