Accidental Decannulation
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Explanation | Ways to Prevent | Signs That Trach Is Out l How to Replace Trach Tube l Tips
What Is Accidental Decannulation?
When the tracheotomy ties are too loose, the tube can be coughed out, tugged out, or can fall out of the airway, and your child cannot breathe easily.
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Ways to Prevent Accidental Decannulation
Here are some ways to help prevent accidental decannulation:
- Check that the tracheotomy ties are secure, dry and intact whenever you suction and throughout the day.
- If the ties are loose, tighten them. If they are tearing, replace them.
- Do not allow your child or any other person pull at the tracheotomy tube.
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Signs That a Trach May Have Come Out
Here are some signs that indicate your child's trach may have come out:
- Fast, noisy, hard breathing
- Restlessness
- Clammy skin, sweating
- Complaints from your child that he or she cannot breathe
- Blue color around lips, nails and skin
- Some children can make sounds louder than they could before it came out.
- No breathing and your child does not wake to your touch or calling his / her name
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How to Replace a Trach Tube
Here are the steps to follow when replacing a trach tube:
- Remain calm, act quickly.
- If someone is with you, call out to them that the tracheotomy tube is out.
- Insert trach tube, as instructed in section titled Tracheotomy Tube Change.
- Call 911 / start rescue breathing and/or CPR: Always get help if your child is having trouble breathing or if you are unable to place the same size tracheotomy tube.
It is ok to slide the old tube that has just come out back in if it is the only tube in the area, and your child is not breathing. Yet, after your child is safe and calm, you should place a clean tube.
Discuss with your doctor, nurse practitioner, nurses or respiratory therapists specific things you can do for your child if you cannot replace the tracheotomy tube.
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Tips
If your child is prone to pulling the tracheotomy ties or tube, self-fastening ties are not a good option for your child. Speak with your nurse or nurse practitoner about other tracheotomy tie options.
If you are washing and reusing self-fastening ties, be sure to check the tie for a secure hold. Also refer to the section called "Tracheotomy Tube Change."
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Rev 7/07
