A tracheostomy (also called a tracheotomy) creates a surgically made opening (called a stoma) in the front of the neck into the airway (trachea). A tracheostomy (tray-kee-OSS-tuh-me) tube, or trach tube, keeps the pathway open so air can go through the trach tube, into the airway, and get to the lungs. Trach ties hold the tube in place. The word "trach" can refer to the procedure, the opening, or the tube itself.

Your child's care team showed you how to care for your child's trach tube and how to deal with emergencies, such as replacing the tube immediately if it comes out.

• Give your child any prescribed medicine as directed.
• Always wash your hands before and after caring for your child's trach tube or stoma.
• Clean the opening around the tube and the skin of the neck as instructed by the care team.
• Follow the schedule outlined by your care team for suctioning the tube, changing the trach ties, and replacing the tube.
• Keep sprays, powders, perfumes, pet hair, and sand away from the trach tube.
• Keep water out of the trach. The care team will show you how to best wash your child's hair. 
• Follow your health care provider's instructions for when your child can return to school, day care, active play, and other activities.
• Always have a bag of supplies with your child in case the trach tube gets clogged with mucus or comes out.

Your child:

• is in pain
• has warmth, swelling, or redness around the stoma
• has a fever 
• has a cough
• 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 a drop in oxygen levels (called desaturation) 
• is very tired or seems anxious
• throws up or has trouble with feeding

• The area around the tube is bleeding.
• There is bright red bloody mucus in the trach.
• 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.

Who needs a tracheostomy tube? Kids who need to be on a ventilator or who can't breathe through the nose or mouth may need a tracheostomy tube. Trachs can stay in place for a long time.

Can a child with a tracheostomy tube speak? Kids may need to learn new ways to speak with a trach tube in place. Ask your child's health care provider if a speech therapist could help 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 tube.