Number 1 hint - The best hint of all is "DON'T PANIC". In an emergency a clear head is a great tool. Also remember all information found here is from our families personal perspective only & may not apply to you. Remember if you are not sure to contact your medical specialest first

High temperature - A Baby's temperature is normally between 36.5° & 37.5° celsius. If the temperature has risen to 38°c quickly call a Doctor. If the temperature has fallen below 36°c quickly call a Doctor.

Trachey change - When doing a trachey change have the following : Clean hands & clean area, new trachey & tie, saline & gauze's to clean & dry the trachey hole & round the neck, a neck role to place under the child's neck & shoulders, suctioning pump to remove secretions, emergency trachey kit in case another trachey or other equipment is needed, & if prescribed Beta cream for if the trachey site looks sore. If your child is young they may need to be restrained {arms wrapped up e.g.: towel or small sheet etc.} Don't feel mean it has to be done. Our changes take about 10 - 15 seconds from old one out to new one in , not tied. Up to 30 seconds is ok but after that the hole {stoma} starts closing up.

Trachey hole closing - On an older child the trachey hole tends to stay open easier than on a baby during a trachey change. Try placing a finger just under the hole & pull down slightly when inserting the trachey.

Blowing on baby - On an older child the trachey hole stays open easier than on a baby. During a trachey change try blowing on Baby's for head, this will make your baby inhale & therefore open the hole as your baby exhales, insert the trachey then.

Hard to insert trachey - Sometimes the trachey tube doesn't slide in nicely. If you use some cream {prescribed by your Doctor} around the end, not up the end of the new trachey before you insert it, this should remedy this.

Sleeping bells - Because trachey Baby's Don't breath air through their voice boxes they are quiet Baby's & sometimes lie awake because you Don't hear them. Try attaching a bell to a wrist band {old trachey tie} so they shake it when they awake.

Trachey ties - We use the blue Velcro ones & generally change them every couple of days. We wash them about 5 times then throw it away & use a new one.

Pinching skin at tie change - A trachey tie change is harder than a whole trachey change as you have to thread both ends of the trachey while its on your child & it can pinch the skin on the neck as you thread. Get the holder to tilt the trachey up slightly as you thread it. Don't tilt the trachey up too much as to tilt the trachey out.

Trachey ties on Baby's - Baby's are small & the ties you get in the box are hard to use, & the Velcro ones are usually too big. Fold the ends of the Velcro ones in to your desired length then stitch them down on a sewing machine with strong water proof thread & your done. Do 2 or 3 at once.

Pump - Take the pump {& emergency kit} when ever you leave home. If you charge your pump all night then use the battery if your out in the day it should work fine. Don't do short charges as the battery's get memory's& hold less charge. Your pump is your child's life line so if you are having problems with it contact your supplier.

Suctioning - Remember weather conditions can affect secretions & too much suctioning can create more secretions. So sometimes a little secretion rattle is alright.

Suctioning techniques - We were first taught to suction Bodee by inserting the cathida to the required mark without suction & once at the mark suction on the way out with a circular tornado like action. This worked fine with Bodee but we've found Kayla has more goo, & if we do it this way it tends to push the goo back down the trachey. So with Kayla we suction from the top & this seems to siphon most of it out then we use the tornado action at the end.

Trachey too dry - A trachey that is too dry is not good. A thermo vent may be needed or machine humidifying may be required.

Talking valve "PMV" - We call it a "chatter box" & found the purple ones the best as Bodee would blow or through them off & the bright purple ones are easy to find. You may not like it because it stands out but we lost 2 clear ones & couldn't find them, yet only lost 1 purple one because the lion at the zoo didn't want to give it back!

Talking valve, how long to leave on - Different kids will tolerate the pmv, chatter box, for Different periods of time. Bodee would where it all the time, but we've found Kayla with her small airway can't tolerate it, as she can't ex spell the air out her nose or mouth.

Feeding & vomiting - Vomiting sometimes occurs when feeding a baby. If this happens roll baby onto it's side to prevent vomit going down the trachey.

Tools not from hospital - A mobile baby com is a must as you can put the washing out etc.& feel a bit more at ease. Don't rely on it, keep checking on baby. We use an apnea monitor which beeps in the baby com if Kayla or Bodee stops breathing.

Snot hiding - Sometimes the secretions hide in the trachey. We're sure Kayla hides hers. Deep suctioning works but you Don't want to do that all the time, so you'll get to know to wait a bit sometimes & they will cough it up into the thermo vent, or at least so you can suction.

Smelly trachey - The trachey's do get a bit smelly sometimes with saliva, so just keep changing ties & clean around the neck & trachey with a damp flannel regularly.

Sounds trachey kids make - Some kids will make sounds or even talk without a chatter box even though your specialist might say they won't make sound. Bodee talked 24 hours after getting his trachey, this was without a pmv, chatter box. He was 16months old & continued to talk through his trachey without a chatter box, however he did speak better with one on. Kayla makes sound without a chatter box too, these sounds are not your "normal" baby sounds, she sounds similar to a gyger counter {very cute} these sounds took Kayla sometime to start doing, she was making clearer sounds with her chatter box on, but now she can't tolerate it.

Up sizing a trachey - Up sizing a trachey should only be done by your specialist. There are Different reasons why this should be done. Here are a few to look for : If you've noticed your child's breathing has sped up it pace over weeks or months, this may indicate the plastic trachey hole is too small & a larger trachey tube may be required : If you notice the skin on the chest area sinking in a lot when breathing in, this also might indicate the plastic trachey hole may be too small & again a larger trachey may be needed : If you find your child choking or gagging every now & then for no apparent reason, this may indicate the plastic trachey is too short & a longer one may be required : Note: As with all these hints contact your specialist first.