Evidence-Based Care of Children With Tracheostomies: Hospitalization to Home Care.
Patricia R Lawrence, Rebecca Chambers, Melissa Spezia Faulkner and 1 others
PMID 32108728WHAT IT FOUND
Children with tracheostomies need tailored suctioning, tube replacement, tie checks, and stoma care.
Family teaching and standardized care are recommended for safe transition home, but many practices rest on expert consensus.
Key findings
01Suctioning should be tailored to the child, done only when secretions are audible or visible or obstruction is suspected, and catheters should be premeasured with suction applied for no more than 5 seconds during insertion and removal.
02Tracheostomy ties should be checked regularly and kept loose enough for one finger; a retrospective study of 109 patients supported Velcro ties over cotton twill ties, with less skin irritation and no accidental decannulation events reported, though the skin breakdown difference was not statistically significant.
03Stoma care should use saline and prepackaged split gauze; hydrogen peroxide and cut gauze are discouraged because they can irritate skin or release fibers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review with no described search, appraisal, or original results, so it summarizes recommendations rather than testing them. The review says empirical research is limited and many pediatric tracheostomy practices rely on expert consensus or outdated guidelines. Some cited evidence comes from small studies or adult settings, so it may not apply to all children with tracheostomies. The article does not provide a home-care protocol or caregiver competency checklist, only notes that such checklists are being developed.
Declared interests
The authors declare there are no conflicts of interest.
The easy way to misread this
Do not read these recommendations as tested protocols. The review states that empirical research is limited and that many practices, including tube change frequency and stoma care schedules, rely on expert consensus.