Management Of Pediatric Patients With Tracheostomy In The Acute Care Setting

Patient Guideline Summary

Publication Date: December 31, 2020
Last Updated: March 2, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the American Association for Respiratory Care (AARC) for the management of pediatric patients with tracheostomy in the acute care setting. It is limited to adults 18 years of age and older and should not be used as a reference for children.

 Overview

 Overview

  • A tracheostomy is a surgically placed tube through the neck into the lungs. It is used to manage the airway in critically ill patients.
  • This patient summary focuses on the management of tracheostomy in children.

Treatment

Treatment

The AARC recommends:
  • using a tracheal cuff only for positive pressure ventilation or preventing aspiration.
    • following cuff manufacturer guidelines.
  • following a standardized protocol.
  • changing a tracheostomy tube at postoperative day 3, as needed to relieve obstruction, and with some regularity at a minimum of 1–2 weeks in patients without an increased risk of complications.
  • regular tracheostomy tube hygiene according to manufacturer’s recommendations to prevent mucus plugging, airway obstruction, and infection.
  • moisture-wicking material, changed daily, placed under the tracheostomy tube to keep the skin dry.
  • regular cleansing of the skin of the neck.
  • coordinating care to reduce hospital and ICU stay.

Abbreviations

  • AARC: American Association For Respiratory Care

Source Citation

Volsko TA, Parker SW, Deakins K, Walsh BK, Fedor KL, Valika T, Ginier E, Strickland SL. AARC Clinical Practice Guideline: Management of Pediatric Patients With Tracheostomy in the Acute Care Setting. Respir Care. 2021 Jan;66(1):144-155. doi: 10.4187/respcare.08137. PMID: 33380501.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.