FastTraCS worked with the ENT physician to determine the key features of the device. The following are design features identified prior to, or during intake design meetings:

• Must be able to detect dislodgement before the tracheostomy tube is completely out.
• Must be able to adapt to various makes and models of pediatric tracheostomy tubes.
• Must be low-profile such as not to prevent the tracheostomy tube from sitting flush against the patient’s neck dressing or skin.
• Must be able to work in the home care setting.

FastTraCS designed and prototyped two separate sensor mechanisms to detect decannulation: a contact switch approach and a light-detection approach.

The contact switch approach integrates a "pogo-pin" into the tracheostomy flange and remains in contact with the tracheostomy dressing, sending out an alert when contact is broken (decannulation, dislodgement). The spring pin can accommodate varying anatomy and small movements, such as breathing and coughing, without breaking contact and sending out a false positive signal. Multiple configurations for the pins and detection circuitry were generated that can be used to provide redundancy.

By contrast, the light-detection method can take two embodiments: one that uses an active light source (such as an LED) and another that makes use of ambient light. In either embodiment, a light-detection sensor is used to monitor for the presence or absence of light. If the amount of light hitting the sensor climbs above a threshold indicating partial or complete dislodgement, the circuitry will notify the user(s). The approach using an active light source provides a more robust detection method as filters and wavelength selection can be used to reduce the probability of false positives or false negatives. Active light source provides the additional safeguard for low-light conditions (e.g. night time, dark room, or clothing blocking ambient light).

Both techniques demonstrated the ability to detect partial and complete tracheostomy dislodgement.