Tracheostomy: How to Protect the Child with a Trach Tube

Dirt and dust

When your child is outside, it is important to protect the trach opening from anything that could blow into it. The Humid-Vent works well to protect the trach opening (Picture 1).

Warmth

The lungs are warm – they are at body temperature, (about 98.6°F).  A breath of cold air can cause the muscles around the airways to tighten or spasm.  If that happens, breathing will be more difficult.

When your child first gets his or her trach, the air needs to be humidified through the mist collar before it goes through his trach and into the lungs. As his lungs get used to the cooler air, the Humid-Vent will provide enough warmth to prevent any serious problems.

Eating and drinking

• Give your child plenty of water or other liquids to drink. This keeps the mucus thin and moist. Moist mucus is easier to cough up or suction out of the lungs.
• If your child chokes or vomits, hold him with his head down or turned to the side until choking stops.
• Place an infant on his side after eating in case he vomits.
• 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. Supervise meals to keep food out of the trach tube. If you see food or liquid in the trach, suction the trach and mouth immediately, then call your doctor.

Clothing

• You do not need to buy special clothing for your child. Do not dress your child 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, but 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 his back with his head over the sink.
• Give your child time to play in the water, but be sure to stay with him even during playtime.
• Use care when bathing your child.
  • Use shallow water.
  • Use the Humid-Vent.
• NEVER LEAVE YOUR CHILD ALONE IN THE TUB.
• Do not let your child take showers.
• CAUTION: Do not use powders, aerosol sprays, perfumes, or cleaning fluids in the same room with 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, he will still want to play. Encourage normal play, but:

• Remove thin objects and small parts from all indoor play areas. Some children like to put these tiny objects into the trach. Avoid tiny toys. Remember that anything that goes in the trach can go directly into the lungs or can block the trach.
• When your child is outside, it is important to protect the trach opening from anything that could blow into it. Either the Humid-Vent or a disposable mask will protect the trach opening.
• Avoid sand boxes.
• Supervise play at all times, especially with other children.Be sure they understand not to touch or pull the trach.
• Unless your doctor tells you otherwise, the only activities your child cannot do are:
  • Contact sports, such as football or soccer
  • SWIMMING – A child with a trach should NEVER go swimming or run through a sprinkler until after the trach has been removed for good and the trach site has healed.

Other safety tips

• Your child should not be around anyone who smokes cigarettes, pipes, or cigars.
• Smoke will irritate your child’s lungs. In public areas, sit in non-smoking sections when possible.
• Your child should not be in direct contact with animals with fine hair. If you have an animal, you will need to dust and sweep more often. Animal hair can float in the air and get into the trach.
• Keep your child away from dust and mold.Try to dust and vacuum every day or every other day.
• Do not use powders, perfumes, chlorine bleach, ammonia, aerosol sprays or other cleaning products in the same room with your child. Particles and fumes can get into the lungs through the trach. This can cause a burning feeling and breathing problems.
• Always carry the travel bag with you (see HH-II-204) when you are away from home and even room-to-room.
• Follow your child’s doctor’s directions for trach care.
• Only people who have been trained by a healthcare professional should do trach care.
• Always have extra trach tubes for an emergency (same size and one smaller). Do not re-sterilize trach tubes. Do not place the trach tube anywhere the temperature is over 120º F (in the car on a hot day for example). Avoid over-inflating the trach tube cuff. This can injure your child’s windpipe.
• Watch for these signs of infection and notify your child’s doctor if there is:
  • Red, inflamed skin at stoma
  • Foul-smelling mucus
  • Bright red blood in mucus
• Take only a few seconds to suction. Take a short break before you suction again.
• Learn CPR.
  • You will learn CPR at the hospital (see HH-II-205)
  • Post CPR instructions near the bedside at home.
  • All your child’s caregivers must know CPR.
  • Post emergency numbers near the phone at home.

Tracheostomy: How to Protect the Child with a Trach Tube (PDF)

HH-II-207 6/12, Reviewed 11/17 Copyright 2012, Nationwide Children's Hospital