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 distress. 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.