Care of a Tracheostomy Tube

ExitCare ImageKeeping the tracheostomy tube clean helps prevent infections and keeps certain trach tubing from plugging. A tracheostomy tube is commonly known as a trach tube. You may have one tube (an outer cannula), or you may have two tubes (an outer and inner cannula). The inner cannula that fits inside the outer cannula is removed for cleaning or replacement. Follow your caregiver's directions as to how often you should change and clean your trach tube.

SUPPLIES NEEDED

  • Towel.

  • Suction supplies.

  • Sterile trach care kit.

  • 4x4 inch (10x10 cm) gauze pads.

  • Sterile cotton-tipped swabs.

  • Sterile trach bandage (dressing).

  • Sterile container.

  • 0.9% saline solution.

  • Small sterile brush (or disposable inner cannula).

  • Roll of twill tape, trach ties, or trach holder.

  • Scissors.

  • Clean gloves.

  • Sterile gloves.

TRACHEOSTOMY CARE

  1. Have all supplies ready and available.

  2. Wash hands well.

  3. Put on clean gloves.

  4. Suction the trach tube as needed.

  5. When suctioning is complete, remove soiled trach dressings, gloves, and suction catheter. Throw away the dressings and coiled catheter in the glove. To coil the catheter, roll the catheter around the fingers. Then, pull the glove off inside out so that catheter remains coiled in glove.

  6. Wash hands well.

  7. Put on sterile gloves.

  8. Fill a container 0.9% saline solution.

  9. Give oxygen as needed.

  10. Clean the inner cannula.

    Nondisposable inner cannula.

    • While only touching the outer part of the trach tube, unlock and remove the inner cannula.

    • Drop the inner cannula into 0.9% saline solution. The saline will loosen secretions.

    • Replace the trach collar, trach tube, or ventilator oxygen source over the outer cannula. Do not attach the trach tube and ventilator oxygen devices to all outer cannulas when the inner cannula is removed.

    • Quickly pick up the inner cannula out of the saline solution. Use a small brush to remove the secretions on the inside and outside of the inner cannula.

    • Hold the inner cannula over the container. Rinse the cannula with 0.9% saline solution.

    • Replace the inner cannula. Secure the locking mechanism.

    • Give oxygen as needed.

    Disposable inner cannula.

    • Remove the new cannula from the packaging.

    • Take out the inner cannula while touching only the outer part of the trach tube.

    • Replace the old cannula with the new cannula. Lock it into position.

    • Throw away the old cannula.

    • Give oxygen as needed.

  11. Clean the outer cannula surfaces with gauze or cotton swabs, extending 2–4 inches (5–10 cm) in all directions under the neck plate. Using a cotton swab, clean the stoma site in a circular motion from the stoma site outward.

  12. Dry the skin and the outer cannula by patting the area gently with a dry gauze pad.

  13. Secure the trach tube with trach ties or a trach tube holder.

  14. Place a sterile dressing around the trach site.

  15. Give oxygen as needed.

  16. Throw away any used supplies.

  17. Remove gloves.

  18. Wash hands well.