When dislodgement occurs, quick recognition and prompt action are key to success. If a suction catheter
cannot be inserted, the tube could be located within a false passage or obstructed by a mucous plug. Table 5 describes the differences between tube dislodgement in a patient who is receiving mechanical ventilation and a patient who is breathing spontaneously in no acute dis- tress. Subcutaneous emphysema or crepitus can occur within the initial incision and move through the stoma into the trachea, allowing air to escape in between the 2 openings. Subcutaneous emphysema, which feels like bubble wrap when palpated, can also be palpated in an inadvertent dislodgement when positive pressure is applied to the tube within a false passage.