Tracheostomy (tray-kee-OSS-tuh-me) tubes, or trach tubes, sometimes get blocked with thick mucus. When this happens, it is hard for a child to get enough air into the airway (trachea). A child with a blocked trach tube can have a hard time breathing. The mucus needs to be cleared out of the trach tube to keep the airway open.

The care team suctioned the trach tube and cleared the blockage. Your child is breathing normally now and can safely be cared for at home. Regular suctioning of your child's trach tube and following instructions to thin your child's mucus can help prevent future blocked trach tubes.

• Follow the care team's instructions for how often to do regular trach tube suctioning.
• Also suction when: 
  • Your child's breathing is noisy, heavy, or quick.
  • Your child is coughing.
  • The skin around your child's trach sucks in.
  • Your child's skin looks pale or their lips look blue.
  • Your child has trouble eating or is fussy.
• Watch closely for changes in mucus thickness and color whenever you suction.
• To help keep mucus thin: 
  • Give your child plenty of liquids.
  • Use a heated humidifier and/or heat-moisture exchanger (HME) with your child's trach tube as instructed by your care team.
  • Your care team may tell you to occasionally mist or squirt a small amount of saline (saltwater) into your child's trach tube. If so, follow the directions given to you by your care team.
• Talk to your health care provider about the best schedule for changing your child's trach tube.

Your child:

• has foul-smelling, thick, or blood-streaked mucus; a change in color of the mucus; or a lot of mucus in the tube
• needs more oxygen than usual
• has desaturations (drops in oxygen levels) 
• is very tired or seems anxious
• throws up or has trouble with feeding 
• has warmth, swelling, or redness around the stoma
• has a fever 
• has a cough

• There is bright red bloody mucus in the trach tube.
• Your child is working harder to breathe.
• Your child still has noisy or heavy breathing or pale skin after suctioning.
• Your child has any of these signs of dehydration:
  • a dry or sticky mouth
  • peeing less
  • no tears when crying
  • dizziness
  • drowsiness

• The trach tube comes out and you can't replace it.
• Your child has a desaturation that does not improve with the steps you have been taught.
• Your child is not breathing or has trouble breathing.
• Your child's lips or skin look blue or gray.
• You have trouble waking your child.

Are there any clothes my child should avoid? Your child should not wear anything that could block the trach tube, such as a turtleneck. Also avoid fuzzy clothing that could shed into the trach.