Patients with a tracheostomy may present to the emergency department with these complications.

  • Tube displacement
    • Accidental dislodgement
    • Migration due to cuff deflation/poorly secured tube
    • Erosion into tissues
    • False passage creation – the tube can become lodged in between soft tissue planes around the neck
  • Tube obstruction
    • Secretions
    • Blood
    • Lodged foreign body
    • Old or faulty humidification device
  • Bleeding
    • Erosion into major vessel including tracheo-innominate fistula
    • Granuloma formation
    • Trauma secondary to suctioning

In a 2004 study, 60% of critical incidents directly affecting patients with tracheostomies involved tube obstruction or displacement, with a significant proportion of these contributing to patient harm.4

In 2014 an NCEPOD review identified 1.2% of tracheostomy patients experiencing major bleeding after tracheostomy.5 A potential cause of life-threatening bleeding is tracheo-innominate artery erosion, which has an incidence of around 0.1-1% in tracheostomy patients.6,7 Tracheostomy bleeding and management is explained in more detail later.

Learning bite

Tube obstruction or displacement are the most common complications seen in patients with tracheostomies.

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