Tracheostomy Baby Home Care Checklist: Gear, Nurses, and Routines

  1. Saline is like water. Saline treatments keep our tracheostomy babies’ respiratory tracts moist and help prevent mucus plugs.
  2. Clean and change tracheostomy ties every day.
  3. Keep a back-up oxygen tank in the room along with a spare ambu-bag.
  4. You should have an oxygen tank positioned under the vent with an ambu-bag attached.
  5. Your oxygen tank should be opened but the gauge closed, so that in an emergency you can simply turn the black knob and start bagging.
  6. Check that your baby is getting enough humidification. Changes in weather can affect the heater.
  7. Have your own stethoscope so you can listen to your baby’s breathing. Your nurse can help you learn what you are supposed to hear, and there are also audio files available on the web.
  8. Ask your nurses how often they listen to your baby’s breath sounds.
  9. Spot-check in the early hours of the morning, since this is the time when nurses sometimes get tired. Do this especially during your first time home from the hospital.
  10. Have a “Go-Bag” stocked with medical essentials, including: emergency numbers, an ambu-bag, a step-down trache, trache ties, a trache care kit, inline suction catheters, blunt scissors, water-soluble lubricant, gloves, a towel roll, bulb syringes, tissues, sterile saline, and a CPR barrier device.
  11. The “Go-Bag” is not a diaper bag. Do not keep emergency items in the diaper bag.
  12. When going to a doctor’s appointment, bring: the “Go-Bag,” the diaper bag, and portable suction.
  13. Ask your day nurses to monitor medications and let you know when supplies are running low. You can also ask them to call the pharmacy for a refill.
  14. A great day nurse is someone who will interact with your baby and not just keep him or her in bed.
  15. A great night nurse is someone who does not sleep — and who cleans the equipment during her shift.
  16. Cleaning equipment at night is part of the night nurse’s job. She should wipe down the baby’s crib before placing the baby in it, as well as other equipment such as the concentrator, suction machine, oxygen tank, high chair, bouncer, walker, stander, and any toys used during the day.
  17. Be nice to your nurses! Nurses are professionals, even though they work in your home. They are not nannies for your other children. A nurse who is treated well will make sure your shifts are covered.
  18. Always ask for an updated schedule from your nursing agency. Show them that you are serious so that they will ensure your hours are covered. Be firm.
  19. It helps to have a dedicated pharmacy that handles your medication refills. They are the ones who contact the doctor’s office when refills are needed, and they also communicate with Medicaid and your insurance to clarify coverage.
  20. Keep coffee, tea, and other drinks in the house, especially for night nurses. They will appreciate it.
  21. Physical therapy, occupational therapy, and speech therapy are priority appointments — second only to doctor’s visits. Cancel only when absolutely necessary, and ask whether the session can be rescheduled. Most therapists are willing to make up missed sessions.
  22. Talk to your therapists regularly so you understand how to do your part in helping your child progress developmentally.
  23. Celebrate your baby’s successes, no matter how small. Progress is progress!
  24. Play with your child. Human interaction is better than screen time!
  25. Pray with your child at night, and whenever possible, be the last person your child sees before going to sleep.
  26. Learn how to change the circuit and heater yourself with the assistance of your nurse. It is a two-person job — do not do it alone!

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