Our tracheostomy rounds team



If your child needs a tracheostomy and is hospitalized at Texas Children’s Hospital, you’re bound to meet a member of our tracheostomy rounds team.

Texas Children’s performs an average of 90 tracheostomies each year. This procedure consists of a surgical incision in the trachea to bypass the upper airway and provide an alternative access for breathing. The need for tracheostomy placement can vary from child to child. Some common reasons behind a tracheostomy include airway obstruction, genetic syndromes, trauma, infection or the need for prolonged ventilator support. In the past, tracheostomies were usually performed to treat infectious diseases like epiglottitis, but these cases decreased following the creation of the effective vaccination to prevent Haemophilus influenzae type B. Nowadays, prolonged ventilation for bronchopulmonary dysplasia and neurologic disorders are the most common reasons tracheostomies are needed.

Our upper airway is responsible for warming and moistening passing air; therefore, humidified collars and other equipment are often functionally required to assist patients with tracheostomy tubes. Caregivers must also use a gentle, careful suctioning technique to prevent suction trauma. Most importantly, children with tracheostomies require 24-hour supervision and specialized care directed with a team approach from the care team and family to promote safety.

Nonetheless, children with tracheostomies require unique attention, and should be followed up by specialized providers. From maintaining essential home equipment to caregiver training, devotion to every detail is needed to prevent tracheostomy-related complications.

Tracheostomy rounds at Texas Children’s

In 2014, Dr. Tiffany Raynor recognized the need for improved staff communication and specialized care for patients with tracheostomies across the hospital. To meet this need, she brought together members from multiple specialties including pulmonology, speech language pathology, respiratory therapy, critical care and nursing.

If your child is hospitalized at Texas Children’s and requires a tracheostomy, you’re likely to encounter our team. We have a group of advanced practice providers including Jennifer Brown, Heena Narsi-Prasla, Tien Pham and myself, Jessie Marcet-Gonzalez, who will take time to meet and evaluate your child. During our assessment, we’ll focus on the tracheostomy stoma for granulation or breakdown, and communicate with you and your care team to promote best practices for education and safety.

We might need to assess the trachea with a flexible scope, which involves a fast, simple procedure allowing us to determine an appropriate tracheostomy tube size and check for infection or obstruction. We also work alongside speech language pathologists to encourage the use of speaking valves if necessary. Each member of our tracheostomy rounds team will bring individualized expertise to your child’s care in order to develop a successful treatment plan.

Outpatient follow up

Once your child is discharged from the hospital, routine outpatient follow-up with an ENT provider is crucial for minimizing the risk of related complications. If you have any questions, we encourage you to contact our team at 832-822-3250. If you’re interested in learning more about Texas Children’s Pediatric Otolaryngology program, click here