Tracheostomy Troubleshooting: Complications and Problem Solving

While tracheostomies are safely performed all the time and can vastly improve an individual’s quality of life, complications can arise.

Learning about these tracheostomy complications and problem-solving techniques prior to the tracheostomy will benefit both the patient and their healthcare providers, allowing them to work together quickly and efficiently to solve any problems.

Awareness is Crucial

Those with a tracheostomy should always keep an eye out for the following signs¹ and contact their healthcare provider if they notice:

• Difficulty breathing
• Increased sputum (mucus) production or changes in sputum colour (from clear to yellow, green, or brown)
• Irritation or soreness of the skin around the stoma (opening) in the neck

Problem Solving

The mainstays of tracheostomy troubleshooting usually involve adjustments in:

• Humidification
• Suctioning
• Tracheostomy tube customisation

Humidification

Blockages are often caused by mucus which has dried and stuck to the tube. Increasing humidification² can moisten these secretions and make them easier to remove.

Suctioning

Sometimes, difficulty breathing with a tracheostomy is caused by a blockage of the tube with mucous secretions. In this case, individuals with a tracheostomy may try suctioning more frequently to make a clear passage for air.

If blood is suctioned², or if the suctioned mucus is tinged pink, a healthcare provider should be contacted immediately to advise on proper suctioning technique and to evaluate for tracheal trauma or infection.

Changing a Tracheostomy Tube

Tracheostomy tubes are changed routinely³ in order to reduce the build-up of bacteria and mucus and to prevent obstruction.

While some tracheostomy complications may occur, including tissue injury or incorrect positioning of the tube, changing a tube once a month at a minimum will prevent more issues than it may cause.

Tackling Emergencies

When living with a tracheostomy, emergency situations may occur. For example, shortness of breath can arise without warning, or the tracheostomy tube may fall out altogether. While both of these situations can be understandably frightening, both are easily solved with calm, prompt action.

If the tracheostomy tube falls out, it can simply be washed, dried, replaced, and secured.

Difficulty breathing may be solved by:

• Coughing
• Removing and cleaning the tube’s inner cannula
• Suctioning

In Conclusion

Despite the possibility of complications, tracheostomies are considered safe and effective ways to improve breathing ability. When problems do arise, however, proper education and teamwork between the individual with a tracheostomy and their healthcare team ensure that these issues can be solved appropriately.

¹ Tracheostomies – Information for Patients and Families (2001, Margaret Codd R.G.N, B.N.S)
² Tracheostomy Patient Guide (Kapitex)
³ Tracheostomy Tube Change (2017, Roisin Mullen CNSp Airways, Siobhan Fitzgerald CNSp Airways)