Pediatric Tracheostomy: The Long Game

In this episode, Dr. Romaine Johnson joins Dr. Gopi Shah and Dr. Ashley Agan to discuss the essentials of building a successful pediatric tracheostomy program and the importance of a multidisciplinary team. He emphasizes that the triage and management of pediatric tracheostomy patients must be approached through the lens of long-term care.

He states that essential members of the multidisciplinary pediatric tracheostomy team include pediatric pulmonologists, advanced practice nurses/nurse practitioners, respiratory and speech therapists, as well as social workers and case managers. Dr. Johnson also describes his multidisciplinary clinic set up through which patients are able to see all members of their care team at a single visit, thereby improving the quality and safety of care.

Dr. Johnson provides some key insights into the management of inherited pediatric tracheostomies with regards to how and when to up-size a trach as well as the role of palliative care in complex pediatric tracheostomy cases. Finally, we go into some notes on how to manage bleeding complications in pediatric tracheostomy patients, including the role of a pulmonary sick plan, and management of anterior/posterior tracheal erosions.