Checklists and Worksheets
My care team worksheet
This sheet is designed to help your family keep all important healthcare contacts and information in one easy-to-use place. By filling in the names, phone numbers, and prescription details of each provider, you and your caregivers will always know who to contact for specific needs or emergencies. Posting this sheet at home makes sure everyone involved in your child’s care is informed, prepared, and confident in managing daily care and urgent situations.
Travel checklist for a child with a tracheostomy tube
Here is what you need to care for your child’s trach when you are not at home. It is a good idea to always have these supplies ready in case you travel unexpectedly.
Equipment
Go bag
Pulse oximeter
Portable suction machine
Portable oxygen (if applicable)
Ventilator (if apllicable)
Self-inflating bag
Go-bag
Dressing supplies
Hand sanitizer
Sat probes
Gloves
Suction catheters
Saline ampules
Humidification (i.e. HME, or saline neb set-up with saline ampules, or ventilator with in-line HME)
Medical information card (diagnosis, medications, allergies, physician phone numbers, etc)
Tracheostomy change
Spare obturator
Spare trach tubes with size smaller (when commercially available)
Water-soluble lubricant
For cuffed tubes: 10mL syringe (for deflating/inflating cuff) – Bivona tracheostomies- pre-fill syringe with sterile water
Pre-cut trach ties
Scissors