Emergency Tube Replacement

Steps for emergency trach replacement

For patients dependent on a ventilator

Follow these steps for an emergency replacement of the tracheostomy tube in a ventilator-dependent patient.

1. Try to stay calm.
2. Place patient in a flat lying down position, perform a head tilt, chin lift.
3. Remove new tracheostomy tube from box
4. Make sure cuff is deflated. Insert Obturator into trach tube, without inner cannula.
5. Guide trach tube into trach opening. If unable to insert tube, place a rolled
   up towel under patient’s neck. Remove Obturator and insert inner cannula.
6. Inflate the cuff as instructed, bag the patient, then place patient back on ventilator.
7. Secure trach tube with trach tie.
8. If patient is unresponsive, call 911, and begin CPR protocol.

For patients not dependent on a ventilator

1. Try to stay calm. The patient can breathe on his own, just needs a trach tube for a short time. Encourage the patient to stay calm.
2. Place patient in a flat lying down position, perform a head tilt, chin lift.
3. Remove new tracheostomy tube from box.
4. Insert Obturator into trach tube, without inner cannula.
5. Guide trach tube into trach opening. If unable to insert tube, place a rolled-up towel under patient’s neck.
6. Remove Obturator and insert inner cannula.
7. Bag patient and secure trach tube with trach tie.
8. Restart tracheal plugging, or place back on Hydro filter, or trach collar setup.
9. If patient becomes unresponsive, call 911, and begin CPR protocol.