What should you do if your patient's tracheostomy falls out,

What should you do if your patient's tracheostomy falls out, especially if they're on the floor? This is super important because tracheostomy related complications account for almost half of all airway related deaths as well as hypoxic brain injury that we see in the ICU. For every patient, start with an airway breathing circulation assessment. Are they in distress? Can they breathe? Can they speak? Are they oxygenating well? What are their vital signs? And if any of this are is abnormal, call for help immediately. Call anesthesia, ICU, whoever's on call at your hospital. As you call for help, also ask for an emergency airway kit and intubation supplies that you might need to secure an oral airway in this patient. Second important thing is you want to put them on supplemental oxygen. Now this could be done through the stoma or you can do it through high flow nasal cannula or you might need to bag mask the patient based on how sick they are. Now one of the most important things to note is when was the tracheostomy placed? Now it's a fresh trache which is less than 7 days. That track has not had enough time to mature. And if the tracheostomy falls out, it's very risky to just reinsert it. You could create a false passage. There's bleeding complications, failed ventilation. So I would not do that. Uh, unless you're trained, unless you're an ICU on a monitored setting, then you could gently try to reinsert it. If it goes back smoothly, great. If it doesn't, don't force it. Now, if the trick has been there for 7 days or more, then you're, you're welcome to just try to reinsert the trick. And it should go in pretty smooth because the track has had time to mature. And if it doesn't, again, don't put pressure and for, don't try to force it in. And if it's not going in, you could always try a smaller size, too. So check the size and type of the trick. Ask for the same size and a size smaller. And if it's there, it's been there for 7 days, then you can again try to reinsert it. So next time this happens to you, don't panic. Assess the patient, call for help. Provide supplemental oxygen and bag masking. If required, reinsert the trachea of 7 days or more. And if not, make sure you have an emergency airway kit at the bedside that you call for early.