Tube Changing

How do I know when to change my child’s trach tube?

It’s a good idea to plan a routine trach change before your child eats to lower the chance that your child will throw up. Your child’s doctor will tell you how often to change the trach tube. You’ll need to change it before the next scheduled time if there is an emergency (see below).

When is it an emergency?

You need to change your child’s trach tube right away if:

  • The tube is blocked
  • The tube slips out of your child’s trachea
  • A suction catheter cannot pass through the trach tube
  • The tube/cuff does not stay blown up (inflated)
  • Your child shows signs of having trouble breathing:
    • Skin is pale or looks blue
    • Muscles between the ribs pull inward (called retractions)
    • Flaring of the nostrils 
    • A higher heart rate
    • You do not see your child’s chest rising and falling as usual (or at all)

What supplies do I need to change a trach tube?

To change the tube you will need:

  • Oximeter
  • Self-inflating resuscitation bag with pop-off valve and facemask
  • Oxygen
  • Suction machine and  the right size catheter
  • 2 trach tubes: 1 that is the same size  and 1 that is one size smaller
  • Trach tie
  • Stoma dressing
  • Syringe
  • Water-soluble lubricant (washes off in water)
  • Scissors
  • Clean, moistened gauze

For double lumen tubes:

  • Make sure the obturator is in place in the tube.
  • Check that the disposable inner cannula is readily available for insertion (if you tube has one) once the tube is in your child.

For adult Bivona tubes: Make sure the obturator lock is working the right way.

How do I prepare and change the trach tube?

Download the following education sheet for step-by-step instructions on how to prepare to change the trach tube and how to change the trach tube.

Trach tube changing education pdf

Whom can I call if I have questions?

If your child needs emergency help, call 911 right away. For more information, please call your primary care provider.