Performing CPR with a Tracheostomy Tube

• Tap and shout.

• Yell for help.

• If alone with a trached adult, call 911 before starting CPR.

• If alone with a trached infant or child, call 911 after 5 cycles of CPR.

• If someone else is present, have them call 911.

• If able, place phone on speaker to call 911 while performing CPR.

• Check that trach is in and look for breathing.

• If decannulated: replace the tracheostomy tube.

• If no response and no breathing, or only gasping: Give CPR.

• Give 30 chest compressions.

• Child must be on a firm, flat surface.

Infant

• Place 2 fingers on the chest; slightly below the nipples.

• Push down on the chest 30 times 1/3 of the chest volume (about 1-1/2 inches). Push hard and fast at a rate of 100 compressions per minute.

• After each push, let the chest come back to its normal position.

Child

• Place heel of 1 or 2 hands slightly below the nipples and push straight down 1/3 of the chest volume (about 2 inches).

• Push hard and fast at a rate of 100 compressions per minute.

• After each push, let the chest come back to its normal position.

Adult

• Compress the chest with the heel of both hands slightly below the nipples and push straight down 1/3 of the chest volume (about 2 inches).

• Push hard and fast at a rate of 100 compressions per minute.

• After each push, let the chest come back to its normal position.

• After 30 compressions, give 2 breaths (1 second each) with the resuscitation bag and watch for rising of the chest.

• Does the chest rise?

• If not, change the trach tube.

After changing the trach tube:

• Give 2 breaths with the resuscitation bag, then continue with 30 chest compressions.

• Follow these steps if:

  • You have attempted to place the same size trach tube 2 times.

  • And you are unable to place the half size smaller trach tube on your second try.

• You will need to give your child breaths using mouth to mouth ventilation.

• Tilt head back to have clear view of neck and stoma.

• Cover stoma with gauze and then tape so that there are no loose edges.

Infant:

• Open airway (head tilt-chin lift).

• Take a normal breath.

• Cover infant’s mouth and nose with your mouth.

• Give 2 breaths, each lasting 1 second.

• Watch for the chest to rise as you give the breaths.

Child/Adult:

• Open airway (head tilt-chin lift).

• Take a normal breath.

• Pinch nostrils and cover child/adult’s mouth with your mouth.

• Give 2 breaths, each lasting 1 second.

• Watch for the chest to rise as you give the breaths.