Fractured swab stick as a foreign body in tracheostomy tube

Tracheostomy is an artificial opening in the trachea in order to provide a clear airway and to remove secretions. Its general indications include upper airway obstruction, prolonged endotracheal intubation, impaired respiratory function, tracheobronchial toilet and to assist in weaning from ventilator. Several complications can be associated with the care of tracheostomy. There have been several case reports of foreign bodies in the tracheostomy tube.  We hereby present a unique case of a broken culture swab stick acting as a foreign body inside a tracheostomy tube and hindering effective ventilation in a head injured patient. We also highlight how a change in the tracheostomy tube was required to remove the foreign body from the tracheostomy tube.