Mechanical

Tracheostomy obstruction / displaced trach

Before / During / After / Pitfalls

Before

  • Identify fresh vs mature trach and type/size if possible.
  • Bring trach kit, suction catheter, replacement tube, BVM with face mask and trach adapter.
  • Call ENT/anesthesia/RT early, especially for fresh trach.

During

  • Oxygenate both face and stoma as needed.
  • Remove inner cannula, suction, deflate cuff, assess patency.
  • If mature and obstructed/dislodged, replace per local algorithm; if fresh, avoid blind reinsertion and get expert help.

After

  • Confirm with EtCO2, secure tube, treat cause of obstruction.
  • Document tube type/size and emergency plan.
  • Educate team/family about emergency steps if appropriate.

Pitfalls

  • Forgetting to oxygenate the face.
  • Blind reinsertion of a fresh trach.
  • No EtCO2 confirmation.

Educational resource only. Use institutional protocols, local policy, and bedside clinical judgment.