Coughing up blood with a tracheostomy

The tracheostomy tube can rub the airway, while dry air, thick secretions, forceful coughing, or suctioning can irritate delicate tissue. Infection such as pneumonia, bronchiectasis, tuberculosis, or another lung condition can also produce blood-stained mucus. A small trace after care is different from ongoing bleeding, clots, or blood that interferes with airflow. The tracheostomy team needs to know the tube type, recent changes, suction depth, humidification, and whether the blood came from the stoma or deeper secretions.

Stay calm, sit upright, and use the airway care plan supplied by your tracheostomy team. Check whether the tube is blocked and follow your prescribed method for clearing secretions; do not push a catheter farther than instructed. Note the time, appearance, and recurrence of bleeding. Do not remove or replace the tube unless your trained plan specifically tells you to. Contact the tracheostomy service or urgent medical service promptly, even when the bleeding settles.

Call emergency services for difficulty breathing, noisy or absent airflow, a blocked tube, rapidly increasing blood, clots, blue lips, severe chest pain, collapse, or unusual drowsiness. If the tube comes out and you cannot replace it using your care plan, treat this as an emergency. Keep the person upright and follow the emergency instructions given by their clinical team.

Ask whether tube position, cuff pressure, humidification, infection, or suction technique could be contributing. Confirm the exact emergency steps for blockage, displacement, bleeding, and when to attend hospital. Bring a list of medicines, including any that affect clotting.