The essential steps in managing a tracheostomy-related emergency are:
- Recognise whether the patient has a potentially patent upper airway or not (known difficult upper airway?)
- Call for appropriate help
- Apply oxygen to the face and tracheostomy
- Assess the patency of the tracheostomy
- Remove a blocked or displaced tracheostomy if the patient is deteriorating
- Basic oxygenation
- Basic ventilation
- Advanced ventilation
These actions can be carried out by:
Primary responders
Any healthcare professional or carer who has received basic training in how to safely look after and troubleshoot a paediatric tracheostomy tube. This person will typically be comfortable performing suction and changing an established tracheostomy tube.
Secondary responders
A healthcare professional with additional advanced airway and resuscitation skills. This person will typically be able to ventilate a child or baby using a facemask, connect up a tracheostomy tube to a breathing circuit and be able to intubate the trachea orally, nasally or via the stoma. Advanced equipment such as endoscopes or laryngoscopes might be needed.