Tracheostomy Care - CPR

If your child has difficulty breathing (very fast or hard breathing, very pale or blue skin, sweating, squeaky, or whistling noise from tracheostomy tube):
  1. Suction the tracheostomy tube at once.
  2. 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:

  1. Have someone call for help while you begin CPR.
  2. Stimulate your child by gently shaking him.
  3. Put your child on his back on a firm surface (like a table or the floor).
  4. Look, listen and feel for breathing.
  5. Suction the tracheostomy tube. Replace it if it is blocked.
  6. Place your mouth or breathing bag over the tracheostomy tube. Give 2 breaths. Check for movement of your child's chest with the breaths.
  7. Check signs of circulation in response to the breaths:
    • normal breathing
    • coughing
    • movement by your child
  8. 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.
  9. 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.
  10. Continue chest compressions and breaths for one minute. Check for signs of circulation.
  11. If there are no signs of circulation, start CPR again (chest compressions and breaths).
  12. 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.
  13. 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.


   
 
CMH-99-128S Content Expires on 12/31/2006

Copyright © 2000 The Children's Mercy Hospitals and Clinics
Kansas City,Missouri                                                           Overland Park,Kansas

This card is provided as a public education service. The information does not replace instructions your physician gives you. If you have questions about your child's care, please call your physician.

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