One of the most dangerous complications of a tracheostomy that nursing home staff need to be aware of, and take actions to mitigate, is that of a clogged trach tube. When a breathing tube becomes clogged with mucus, saliva, or any other materials, the ability for the nursing home resident to breathe through the tube can be severely impaired. To make matters worse, the nursing home resident is often unable to signal for help or communicate that they are having trouble breathing, leaving them to literally suffocate without any help. If the clog and oxygen deprivation is not fatal, it can lead to long-term or permanent complications, including organ failure, psychological harm from the trauma, and brain damage.

Clogged breathing tubes occur as a result of neglect; while mucus and other material build up may be unpreventable in a tube and form naturally, nursing homes are responsible for inspecting tubes, making sure that the tubes are clear and cleaning them if not, and constantly monitoring patient breathing in order to prevent oxygen deprivation.

In addition to clogged breathing tubes, other preventable complications regarding tracheostomies include infection in the trachea, and removal of the tracheostomy tube (accidental decannulation). Those patients who are elderly, are immunocompromised, or have chronic conditions or respiratory infections are at a greater risk of complication.