Tracheostomy Care

Description
This topic describes daily care of a tracheostomy tube

Cleaning a Tracheostomy Tube is necessary to remove secretions, prevent infections, to keep an opened airway, and make breathing effortless.

What you'll need

  • Hydrogen Peroxide
  • Sterile Water
  • Cotton tipped swabs
  • Small soft “Trach brush” (where can I get one, what if I don’t have one, are alternatives ok?)
  • 3 paper cups 2 cups labeled Hydrogen Peroxide
  • 1 cup labeled Sterile Water
  • Roll of paper towels
  • Special guaze “Trach Dressings”
  • Disposal Bag
  • Suction equipment (tested and functional)
  • Suction catheter
  • Sterile Water
  • Flat, cleared and cleaned area

Task time

30 minutes

Steps

  1. Cover flat cleared and clean area with paper towels
  2. Assemble all supplies and equipment
  3. Discuss cleaning and care procedure before and during process with recipient
  4. Wash your hands, and wear disposable gloves
  5. Place 3-4 cotton tipped applicators in paper cups filled and labeled 1 for Sterile Water and 1 for Hydrogen Peroxide. Fill the 3rd paper cup with Hydrogen Perioxide.
  6. Suction trach first to clear airway
  7. If the trach tube is designed with an inner tube (called a cannula), remove the inner tube by dialing to unlock it. Refer to trach manufacturers instructions (If the trach is designed with only 1 tube, skip steps 6, 7 and 12.)
  8. Place the inner tube (called the cannula) in the paper cup filled with Hydrogen Peroxide (soaking will break up dried secretions and make cleaning with the cotton tipped applicators easier)
  9. Clean around the trach to remove any dried secretions with 1-2 of the cotton tipped applicators from the Hydrogen Perioxide cup. Wash with 1-2 cotton tipped applicatiors from the Sterile Water Cup. Discard all applicators in disposal bag after use
  10. Replace soiled neck band by holding onto both the sides of the trach tube and by pressing gently on one side and then the other, lifting and removing the soiled trach neck band, and replacing and securing it with one end of the clean neck band at a time, until both sides of the soiled neck band have been removed and a new neck band is now in place. Adjust the back of the adjustable band for comfort
  11. A special dressing called a trach dressing (it is a rectangular shaped gauze with a cut out area that fits around the trach) should be place under the neck band and around the trach tube to prevent skin irritation
  12. Complete cleaning of the inner cannula that was soaking in Hydrogen Peroxide, rinse with sterile water, dry, reinsert into trach and lock into place
  13. Confirm placement/comfort with recipient.

If the trach has an inner tube (cannula) how often should the inner tube (cannula) be taken out and clean? Every 4-6 hours and more often if secretions are building up on the inside and requiring more frequent suctioning.

What if the trach does not have an inner tube (cannula)? Suction the trach tube as often as necessary to keep the trach tube free of secretions and the airway free of blockage. Unless you have been trained do not remove the trach tube.

For more information

Tracheostomy Care http://www.healthsquare.com/mc/fgmc0413.htm

Aaron’s Tracheostomy Page http://www.tracheostomy.com/

Aaron’s Trach Tube Change http://www.youtube.com/watch?v=T-Hh21TdB4w

MedlinePlus Medical Encyclopedia: Tracheostomy http://www.nlm.nih.gov/medlineplus/ency/article/002955.htm

Acknowledgements

Thanks to hawknurse for posting a great video.