Inpatient Tracheostomy services

Our trach/vent nurses meet with families prior to tracheostomy placement to begin teaching and to discuss life with a tracheostomy and/or home ventilator. This relationship and teaching continues throughout the initial hospital stay, subsequent hospitalizations, and procedures.

Multidisciplinary care

Your child will receive care from multiple expertly trained physicians including pediatric pulmonologists, pediatric otolaryngologists, neonatologists, pediatric critical care specialists and pediatric anesthesiologists.

Your trach/vent team will consist of a trach/vent nurse, trach/vent respiratory therapists, a social worker and inpatient case manager.

Care coordination

• Pre-operative consultation and teaching with family
• Weekly care conference with family focusing on three criteria for discharge
  • Medical stability
  • Caregiver training completion and progress
  • Identification of community resources

Expert care before and after surgery

Prior to tracheostomy placement, neonates are cared for in our neonatal intensive care unit and older children are cared for in our pediatric intensive care unit. When a neonate is ready to transition to a home ventilator, their care is transitioned to the pediatric intensive care unit. Bedside teaching begins with the first consultation by our trach/vent nurses and continues in both the NICU and PICU. Families will have multiple opportunities to practice hands on care for their child that culminates in walks off the unit with all the equipment needed to go home. Simulation training is used to train for trach related emergencies. A period of independent care gives caregivers the opportunity to simulate a home experience with their own home equipment while still in the hospital.

Caregiver training

Your child’s care is most important!

Since the time you learned that your child needs a tracheostomy, you have met many new people who will help you and new things about the care your child will need.

Family and trained caregivers

As you start thinking about and getting ready to take your child home, you are going to need the assistance of the trach team members. More importantly, you will need the support and help of family and others.

Your child must be attended, at all times, by an adult caregiver who is trained to do trach care and knows emergency trach care. You will need at least one other adult to be completely trained in your child's care. This person is an important adult who will continue to be involved in your child's life after discharge. They will spend time with your child and be a resource for you if you need to be away from your child.

Bedside care and home equipment teaching

Before your child can go home, caregivers will need to learn and demonstrate the care that your child needs. This will happen each time you visit your child. Your goal is to independently provide all of your child’s care each time you visit. Training includes learning about your child's:

• Physical care
• Care of the tracheostomy
• Giving medications
• Feedings
• Equipment care

You will work closely with the nurses and therapists to learn your child's daily care as described in this Care Notebook. You will learn to:

• Suction
• Give breaths with the resuscitator bag
• Do trach care
• Change trach ties
• Change the trach tube

Once you have mastered these skills, you will learn about caring for, setting up and cleaning the respiratory equipment.

Before going home, you will also learn CPR.

Simulation training

The final step of your tracheostomy and home ventilator teaching is simulation. You will “simulate” or practice 3 realistic situations that could happen at home using a special doll. This lets you work together as trained caregivers to troubleshoot real life emergency situations while in a “home environment” with the equipment that will be in your home. 

Independent Cares

Shortly before your child goes home, you will do "Independent Cares."

Independent Cares is an exercise where caregivers provide all the care your child will need at home, but it is done while still in the hospital. During Independent Cares, you spend 6 - 24 hours continuously caring for your child. You will use your child's own home equipment and supplies. The purpose of Independent Cares is to simulate the home environment and to assure that you are prepared to provide all the care and manage all the equipment your child needs.