The next step in our trach training was learning how to complete Karlie’s daily trach cares. It’s extremely important to keep her stoma clean to keep her healthy and prevent any infections. All of our training was done with baby dolls which is obviously much easier than the real thing. Trach cares requires two people and has always been my least favorite daily task. One person holds Karlie’s trach in place and the other person cleans around the stoma, cleans Karlie’s neck, replaces the gauze around the stoma, and replaces the trach tie. It’s important to keep Karlie still and calm which is easier said than done. Since I visited Karlie every day in the NICU, I began doing her daily trach cares with the help of either the nurse or a respiratory therapist. It felt like such a daunting task and I dreaded it every day. Nothing bad ever happened, it just took a while for me to build my confidence when dealing with the trach.

Once we both felt confident with trach cares, it was time to learn how to change the trach. That was the task I dreaded most and was most intimidated by. It’s a skill that you absolutely have to master if your child has a trach. You cannot be in a situation where the trach needs to be changed and not know what to do. Thankfully when it was my turn to change the trach I had the support of one of my favorite NICU nurses and our trach educator. It was just us in the room so I didn’t have to feel rushed or pressured. Changing the trach is actually very quick and my first time went very smoothly. The person holding the trach in place slowly takes the trach out and then the other person carefully slides the new trach in. All in all the trach change takes about 5-10 seconds. It’s important to have all emergency supplies ready just in case things don’t go smoothly. We always have a smaller trach and Karlie’s breathing bag on standby just in case.

CPR was the final skill we had to master before we would be able to take Karlie home. We went through every scenario and were taught what to do in each situation. In each scenario I asked, “Okay, and then what? And after that?” I wanted to know step-by-step what to do in case of emergency. Our instructor assured us that we would likely never need these skills but I wanted to feel confident if we ever found ourselves in an emergency situation. I knew with our luck these skills would be put to the test.