Bedside Tracheostomy Supply Requirements
Every bedside caring for a tracheostomy patient must have a dedicated emergency box containing both routine and emergency airway equipment immediately available, as simple equipment failures have caused preventable deaths in tracheostomy patients. 1
Essential Bedside Equipment (Must Be Immediately Available)
The following supplies should be at every tracheostomy patient's bedside in a dedicated emergency box 1:
Airway Management Supplies
- Spare tracheostomy tubes:
- One the same size as current tube
- One tube one size smaller
- Clean pot for spare inner cannula
- Scissors and stitch cutter (if tracheostomy tube is sutured in place)
- Water-soluble lubricating jelly
Suction and Secretion Management
- Functional suction system with appropriate suction catheters 1, 2
- Sterile water for cleaning the suction tube
- Humidification equipment
Wound Care and Maintenance
- Sterile dressing pack
- Tracheostomy dressings
- Tracheostomy tapes
Safety and Communication
- Personal protective equipment (gloves, aprons, eye protection)
- Sterile gloves for performing deep suction
- Nurse call bell (patient may be unable to call for help verbally)
- Communication aids (patient may not be able to verbalize)
- Bedside equipment checklist
Emergency Equipment (Must Be Available Within Minutes)
These items should be immediately available in critical care areas or accessible within minutes (e.g., on cardiac arrest trolley) in ward areas 1:
Basic Airway Equipment
- Oxygen source (may require two oxygen supplies - one for face, one for tracheostomy) 1
- Oxygen masks
- Self-inflating manual resuscitation bag 2
- Oral and nasal airways
Advanced Airway Equipment
- Laryngeal mask airways
- Laryngoscopes with appropriate endotracheal tubes
- Waveform capnography (essential - should be used at beginning of assessment) 1
- Fiberoptic scope (suitable for immediate use) 1
- Bougies
- Tracheal dilators (controversial - should be agreed upon locally based on patient characteristics and clinician preference) 1
Critical Implementation Points
A complete tracheostomy kit must accompany the patient wherever they go in the hospital - not just remain at the bedside 2. This is a common pitfall that leads to preventable emergencies when patients are transported.
The multidisciplinary guidelines emphasize that waveform capnography and fiberoptic scope availability is non-negotiable for all tracheostomy patients 1. In critical care and specialist areas, these must be immediately at bedside. In general ward areas, they must be available within minutes, and all staff must know how to access and operate them around the clock.
Common Pitfall to Avoid
Many institutions fail to appreciate that equipment must be functional and staff must be trained in its use before emergencies occur 1. Having supplies present but non-functional or staff unfamiliar with their operation defeats the purpose of bedside availability. Regular equipment checks using the bedside equipment checklist are essential.
The evidence consistently shows that proper equipment preparation at the bedside significantly reduces complications and mortality in tracheostomy emergencies 1, 2, making this supply list a patient safety imperative rather than a suggestion.