Tracheostomy Care: How to Protect a Child With a Trach Tube

The air your child breathes goes through the trach tube right into the lungs instead of first being filtered through the nose and throat. It is important to protect the air that goes into your child’s lungs since it is not filtered.

Basic Care

  • Always carry the trach “Go-Bag” bag with you when you are away from home and even room-to-room.
  • Only let people who have been trained by parents or the health care team do trach care.
  • Always have extra trach tubes for an emergency (the same size and one smaller).
  • Do not place extra trach tubes anywhere the temperature is over 120º Fahrenheit (F) or 49º Celsius (C). For example, do not leave them in the car on a hot day.
  • Watch for these signs of infection and call the doctor or health care provider if there is: red, inflamed skin at the stoma, bad-smelling mucus, or bright red blood in mucus.
  • Learn CPR at the hospital after your child gets the trach. Any other caregivers should also know CPR. Keep CPR instructions and emergency numbers close by.
  • The Humid-Vent® is a piece you can attach to the trach that protects the trach opening (Picture 1). See ‘Dirt, Dust, and Irritants’ below.

Dirt, Dust, and Irritants

  • Protect the trach opening from anything that could blow into it. You can use a Humid-Vent.
  • Keep your child away from dust, pet hair, and mold. Dust and vacuum every day or every other day.
  • Smoke will irritate your child’s lungs. In public areas, sit in non-smoking sections when possible. Stay away from anyone smoking. This includes pipes and cigars.
  • Do not use powders, perfumes, chlorine bleach, ammonia, aerosol sprays, or other cleaning products in the same room as your child. Particles and fumes can get into the lungs through the trach. This can cause a burning feeling and breathing problems. 

Warmth

The lungs are warm. Cold air can cause the muscles around the airways to tighten (spasm). After the trach tube is placed, the lungs will need moist, warm air through a ventilator, mist collar, Humid-Vent, speaking valve, or cap. 

Eating and Drinking

  • It is important to keep your child well hydrated. This keeps the mucus thin and moist. Moist mucus is easier to cough up or suction out of the lungs.
  • Hold infants upright after eating in case they vomit.
  • Turn your child’s head so that anything he spits up will flow away from the trach.
  • Keep the trach tube loosely covered during feeding.
  • Watch your child while they eat to make sure food stays out of the trach tube.
  • If your child vomits or you see food or liquid in the trach, turn their head to the side and suction the trach and mouth right away. Then, call your doctor or health care provider. 

Clothing

  • You don’t need to buy special clothes for your child. Do not put them in turtleneck shirts. Keep clothing away from the trach tube.
  • Avoid necklaces, strings, fuzzy clothing, fuzzy blankets, and stuffed animals. Tiny beads or fibers can get into the trach and make it hard for your child to breathe.

Bathing Your Child

  • You may bathe your child in a bathtub with a low level of water.
  • DO NOT let water get into the trach.
  • Place a Humid-Vent on the trach to help keep water out of your child’s lungs.
  • To shampoo, lay the child on their back with their head over the sink. Always support their head and neck. This keeps water from going down their neck and protects the trach. 
  • Give your child time to play in the water, but always stay with them.
  • An adult must watch children in the bath. Do not get distracted.
  • Use shallow water.
  • Never leave your child in the tub alone, even for a moment.
  • If showering, point the water down and away from their neck and trach.
  • CAUTION: Do not use powders, aerosol sprays, perfumes, or cleaning fluids in the same room as your child. Particles and fumes can get into the lungs through the trach. This can cause a burning feeling and breathing problems.
  • Have the suction equipment ready to use, if needed.

Playing

Even though your child has a trach, they will still want to play. Let them play, but follow these rules:

  • Remove thin objects and small parts from all indoor play areas. Some children like to put tiny objects into the trach. Avoid tiny toys. Remember: Anything that goes in the trach can go right into the lungs or can block the trach.
  • When your child is outside, protect the trach opening from anything that could blow into it. Something like the Humid-Vent, speaking valve, or cap can protect the trach opening.
  • Avoid sand boxes.
  • Watch your child during play at all times, especially with other children. Be sure they know not to touch or pull the trach.
  • NO contact sports, like football or soccer.
  • NO SWIMMING – A child with a trach should never go swimming or run through a sprinkler until after the trach has been removed, and the trach site has closed.

 

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