First I heard the monitor alarm is going off, so I asked my neighbour if she was ok, and she said no.
I quickly ran to her room and she said press the blue bottom so I did.
We never had tracheostomy dislodgement before so not quite sure the correct procedure to deal with it.
So I debrief with senior nurse after the event, and we believe the correct procedure is to take the trachea out, occlude the tracheostomy and put gadal airway in the mouth and ventilated through gadal.
Anyway, during the actual event, other senior nurse took the trachea out and occlude the tracheostomy, then I tried to help the doctor to bag valve through face mask via mouth.
Meantime the consultant tried to save the airway, and we also prepare for emergency intubation incase we can't save the tracheostomy.
We did successfully put the trachea back in (either same size or smaller size), and we did a bronchoscopy as well.
Oh and we need to make sure portable EtCO2 is set up and ready to go, and set up the ventilator if it's not ready.
Other things to consider to have at bedside is to have a child size face mask available, a one size down trachea, and a dilator just in case this kind of dislodgement happened.
My biggest dilemma is that I wasn't sure if the trachea is partially dislodged or fully dislodged, and apparently if you lost SaO2 then it's considered fully dislodged.
A very hectic day but also good learning experience about tracheostomy dislodgement.
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