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Patient Safety Moment – Fresh Tracheostomy Patients

Patient Safety Moment – Fresh Tracheostomy Patients


Reported incidents involving patients with fresh tracheostomies (trachs) raising concerns over airway compromise.


If vital pieces of equipment are not present at the bedside, there can be a delay in providing proper ventilation to the patient. There is enhanced risk for patients traveling to a test away from the room where the equipment was kept.


There was a need to assure consistent practice and knowledge regarding the proper equipment to have on hand for tracheostomy patients. A multidisciplinary team met to review best practices in the care of fresh tracheostomy patients.


  • A spare tracheostomy tube of the same size/style that was placed in OR should be kept at the bedside as well as Velcro tie, Surgilube, and Yankauer suction. The spare tube should travel with the patient.
  • Obturator should be taped to the wall at the head of bed and transported with patient if patient leaves the floor.
  • Size 5 cuffed endotracheal tube should be kept at the bedside (for emergent ventilation if trach comes out).

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