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Pediatric Tracheostomy (trach) Care: Crucial Instructions

Pediatric Tracheostomy (trach) Care: Crucial Instructions

Specialized nursing is required to benefit from optimal pediatric tracheostomy (trach) care. There is an increased risk in children of upper airway disorders caused by the artificial airway.

In order to have safe and effective trach care, it’s important to receive the help of home care nurses.

Children with tracheostomies require unobstructed air flow. If you’re caring for such a child, here are a set of crucial instructions you need to know.


Traditionally, pediatric tach requires suctioning after every two hours. It’s best to use suction catheters when there are the following signs:

  • Decreased oxygenation
  • Low breath sounds
  • Audible secretions

The American Thoracic Society (ATC) recommends daily suctioning at bedtime to avoid unnecessary suctioning and to ensure tracheostomy tube patency.

Follow these guidelines while suctioning for pediatric patients:

  • Make use of a multi-holed suction catheter which has side holes placed near the distal end. This will help to remove the secretions from a much larger surface area.
  • During the insertion and removal of the suction catheter, a rapid technique is more effective. To prevent atelectasis (lung collapse), ensure that you do not apply suction for more than 5 seconds.
  • Instead of stirring the catheter with your hand, try to twirl it between your fingers and thumb. This will help to reduce friction and facilitate the removal of secretions from each area of the tube.
  • Use a large-sized catheter as it removes secretions faster and more effectively than a small-sized one. Select a catheter which is easy to insert while having a similar size to the tube’s diameter.

Trach Tube Changes

The trach tube may become clogged with mucus, which makes it hard for the child to breathe. It may also lead to infection. This is why weekly trach tube changes are recommended. The best time to change the tube is before the child eats.

If you are carrying this out on your own, follow these steps:

  • Wash and dry hands thoroughly
  • Prepare a new set of trach ties and secure them to the clean tube.
  • Ensure that the tube is aptly lubricated when inserting the obturator (muscles covering the outer pelvis) into the tube.
  • Suction the child’s tracheostomy as mentioned in the above section
  • When inserting the new trach tube, lay the child on their back, place a rolled blanket beneath the shoulders, and tilt their head back slightly.

Note: Do not tilt back the head too far as it could make the insertion of the new tube difficult.

Professional Home Health Care Services

Professional Home Health Care Services

Providing excellent trach care to a child requires the

help of professionals. Golden Health Services is based in Philadelphia, PA and offers quality, dedicated home care services. We specialize in pediatric tracheostomy care as well as ventilation care and medication administration.

Contact us at (215) 289-9005 to learn more.

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