Understanding the Anatomy
A tracheostomy or stoma is an opening in the neck that connects directly to the trachea. Patients may have a tube in place, while some laryngectomy patients have a permanent stoma with no connection to the mouth or nose.
Ventilation and Suctioning
If the patient needs ventilation, you can attach a BVM directly to the tracheostomy tube or use a pediatric mask on the stoma. If the stoma is open, seal the mouth and nose only if there is a connection to the upper airway. Suction the tube with a sterile catheter, using shorter attempts than normal.
Common Problems
Mucus plugs are the most common cause of acute distress. Try suctioning first, and if the tube is blocked you may need to remove it per protocol. Ask caregivers about the tube type and any emergency equipment, because they are often the best source of information.