If your child has
difficulty breathing (very fast or hard breathing, very pale or
blue skin, sweating, squeaky, or whistling noise from
tracheostomy tube):
- Suction the tracheostomy tube at once.
- Replace the tracheostomy tube if:
- a tube comes out
- the tube is blocked with mucus
- your child’s breathing does not improve with
suctioning
Perform CPR (Cardiopulmonary Resuscitation) if your child
stops breathing:
- Have someone call for help while you begin CPR.
- Stimulate your child by gently shaking him.
- Put your child on his back on a firm surface (like a
table or the floor).
- Look, listen and feel for breathing.
- Suction the tracheostomy tube. Replace it if it is
blocked.
- Place your mouth or breathing bag over the tracheostomy
tube. Give 2 breaths. Check for movement of your child's
chest with the breaths.
- Check signs of circulation in response to the breaths:
- normal breathing
- coughing
- movement by your child
- If there is movement but no breathing, continue to
breathe with a breathing bag or your mouth:
- once every 3 seconds for children under 8 years of
age.
- once every 5 seconds for children over 8 years of
age.
- If there is no signs of circulation:
- For Infants:
Press straight down 1/3 to 1/2 the depth of the chest,
using two fingers on the breastbone and one fingerwidth
below the nipple line at a rate of at least 100 times
per minute. Do not lift your fingers off the chest. Give
5 compressions then give a breath.
- For Children 1 to 8 years of age:
Press straight down 1/3 to 1/2 the depth of the chest,
using the heel of one hand on the lower half of the
breastbone at a rate of at least 100 times per minute.
Give 5 compressions. Then give a breath.
- For Children over 8 years of age:
Press straight down 1/3 to 1/2 the depth of the chest,
using the heel of both hands on the lower half of the
breastbone at a rate of 100 times per minute. Give 15
times compressions. Then give 2 breaths.
- Continue chest compressions and breaths for one minute.
Check for signs of circulation.
- If there are no signs of circulation, start CPR again
(chest compressions and breaths).
- If there are signs of circulation, but your child is
still not breathing, continue giving a breath:
- every 3 seconds if your child is under 8 years of
age.
- every 5 seconds if your child is over 8 years of
age.
- If you are alone:
Go to a telephone (move your child with you, if possible)
and call your emergency number (911) to get help. After
calling, check your child again and start CPR if needed.
Safety Precautions:
- Post the emergency phone number (911) and your
home address by all telephones.
- If your child stops breathing: Suction and change the
tracheostomy tube as needed before starting CPR.
- Discuss emergency plans with all family members.
- Seek medical help immediately, even if your child
improves quickly with CPR.
- If your child is taken to a hospital by ambulance, go
with him to help, if possible. Take along a clean
tracheostomy tube of the same size and a smaller one.
See other Tracheostomy CARE Sheets for information on
tracheostomy care, suctioning the tracheostomy, changing the
tracheostomy ties, cleaning the tracheostomy tube and changing
the tracheostomy tube.
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