This webpage is intended as a summary guide for information and further reading. It is not intended to replace proper training for managing patients with tracheostomies.
The Intensive Care Society, Faculty of Intensive Care Medicine and National Tracheostomy Safety Group (NTSG) have produced a booklet about Tracheostomy Management and Guidance. There are some great resources on the NTSG website. ** ignore information about laryngectomy patients**
There should be a daily care regimen for patients with tracheostomies. An example of this practice has been written by a group in Manchester shared on NTSG website and is available to download below.
Emergency procedures
It is important to be familiar with emergency management of tracheostomy in case of obstruction or dislodging. All patients should have a green sign above their beds indicating the type and size of tracheostomy as well as date of insertion.
All patients should have a bedside box that includes a the same size tracheostomy and one below, tracheal dilators, stitch cutters if needed and spare tapes.
It is important to try to relieve any tracheostomy obstruction but ultimately if it is obstructed despite emergency manoeuvres then it should be removed, and oxygen can be applied to both the stoma and face. The patient may need to be reintubated and the difficult airway trolley should be available.
Full written emergency guidance is available to download below: