Tracheostomy emergencies can result in rapid airway loss. These situations require calm, structured assessment and immediate action to re-establish airway patency and oxygenation. Know the type of tracheostomy, time since placement, and always be prepared to manage a difficult airway.”
???? PROVIDE:
???? What Is a Tracheostomy Emergency?
A tracheostomy emergency refers to any acute complication involving a tracheostomy tube that leads to:
- Respiratory distress
- Tube dislodgement
- Bleeding
- Obstruction
- Loss of airway patency
It can occur in new (fresh) or established tracheostomies and can be life-threatening.
⚠️ Common Emergencies
1. Tube Dislodgement
- Early (<7 days): Stoma is immature → do not blindly reinsert
- Late (>7 days): Stoma is more stable → re-cannulation may be possible
2. Tube Obstruction
- Mucus plug or dried secretions
- Kinking or malposition
- Blood or foreign body
3. Bleeding
- Minor: Local irritation, granulation tissue
- Major: Tracheo-innominate fistula (life-threatening, sentinel bleed!)
4. Infection
- Local cellulitis or abscess
- Pneumonia or tracheitis
5. False Passage
- Occurs if tube is replaced into soft tissues instead of tracheal lumen
???? Assessment Steps (ABCDE Focused)
????️ Airway
- Is the patient breathing? Is the tube patent?
- Listen for airflow through trach
- Check for chest rise, fog in tube, suction catheter passability
????️ Breathing
- Check oxygen saturation, RR, use of accessory muscles
???? Immediate Actions:
- Administer 100% oxygen via trach and/or face mask over mouth/nose
- Suction the trach to check for blockage
- Attempt to pass a suction catheter:
- If it passes, the tube is likely in place
- If it doesn’t, suspect obstruction or false passage
????️ Emergency Management
???? If Tube Is Dislodged or Blocked
- If patient is stable:
- Remove the tube
- Attempt to replace with new trach (same size or smaller)
- If cannot replace → oral intubation or ENT for surgical airway
Attach
Search
Study
