Tracheostomy and Home Ventilator Program

Caring for a child who has a tracheostomy requires experience that only a pediatric team of experts can provide. At Children's Hospital of Wisconsin, we care for children who require a tracheostomy and also children who require a tracheostomy with a home ventilator. Our multidisciplinary approach and commitment to the highest quality of care makes our program the premier tracheostomy/home ventilator program in the region.

Program highlights

  • We have treated over 700 children with tracheostomies since the inception of our program in 1984.
  • Our program was one of the first in the country to discharge children to home on a ventilator.
  • We currently care for almost 200 children living in the Midwest.
  • The Tracheostomy/Home Ventilator Program is part of the Division of Pediatric Pulmonary and Sleep Medicine, which was named among the nation's best by Parents magazine in its 2013 Best Children's Hospitals survey and in U.S. News & World Report's 2014-15 Best Children's Hospitals report.

 The Family Experience

  • We believe that trust, education and open communication are the key components to building strong relationships with children and their families, especially when a tracheostomy is first being discussed.
  • We have a multidisciplinary team that works closely with each child and his or her family. Team members include a pulmonary physician, otolaryngologist, respiratory care practitioner, social worker, speech therapist and case manager. An advanced practice nurse or nurse clinician is assigned to work with the family to manage and coordinate both inpatient and outpatient care.
  • All families and caregivers participate in a training program to prepare them to care for their child with a tracheostomy at home.
  • All of our home care nurses receive ventilator training certification required by the state of Wisconsin to care for a child on a home ventilator.
  • We work closely with school nurses and educators to facilitate the child's transition back to school.
  • Our speech therapists educate and share information with local community speech therapists to promote effective therapy plans to care for a child with a tracheostomy.
  • We contact local EMS services and energy companies alerting them that a child is on a ventilator in their area.

Quality and Outcomes

  • Our program sees approximately 30 to 40 new children every year who require a tracheostomy. Approximately half of the children require only a tracheostomy and the other half require a tracheostomy with a home ventilator.
  • The number of children who are ready for decannulation, which means the child is off the ventilator and ready to have their tracheostomy removed, varies per year. Readiness to decannulate depends on the child's underlying condition, ability to breathe without a ventilator, and the ability to maintain an open airway.
  • We have reviewed outcomes for 46 children who had a tracheostomy and were on a home ventilator that were successfully liberated from their home ventilator and decannulated between July 1999 and December 2011.
  • The median age these children discontinued using a home ventilator was 25.5 months.
  • The median age these children decannulated was 40.5 months.
  • The majority of these children did not require home oxygen after decannulation.