The next part of this session covers general and specific nursing care of a tracheostomy.

Many tracheostomy problems can be prevented by good, basic nursing care. This can avoid problems with tube blockage, keep the stoma healthy and keep the tube secure.

Fig 1 shows a child with a new tracheostomy. Table 1 describes his initial care.

New tracheostomies can bleed a little after initial insertion and minor bloodstained secretions are not a cause for concern. Fresh red blood from the stoma or aspirated from suctioning should trigger a prompt review from the surgical team.

Insertion of a tracheostomy can be a worrying time for families and is often the end result of a prolonged period of assessment and discussion about what is best for the child.

Fig 2 is a video which describes the journey towards a new tracheostomy for three children and the impact it had for the child and their family. The family are often heavily involved in the care of their child and should be encouraged to learn about and to help with tracheostomy care if appropriate.

Fig 3 is a short video showing how a parent can quickly learn to undertake complex tracheostomy care and get involved in the day-to-day management of tracheostomy care.