Tracheostomy Care
Supplies
Daily use of hydrogen peroxide may cause skin irritation for some patients. Saline wash may be considered a substitution.
Inner cannulas:
· Disposable inner cannulas should be changed and discarded daily.
Reusable cannulas:
· This cannula should be cleaned 1 to 3 times a day - more often if needed.
· Do not leave the inner cannula out for more than 15 minutes as harmful drying of tissue will occur
Supplies
Procedure
Remove gloves and wash your hands thoroughly.
- Sterile cotton swabs
- Medical weave-gauze (‘unfilled’ gauze – do not use cotton-filled gauze)
- Sterile water Hydrogen peroxideTrach ties (cut to appropriate length)
- Two sterile cups or clean disposable paper cups
- Sterile gloves if available
- Medical moisture barrier pad
- Wash your hands - sterile gloves recommended
- Lay moisture barrier pad (medical pad) on a counter or table top
- Lay supplies on pad
- Pour 1/2 strength hydrogen peroxide into one cup and sterile water into the other
- In 1/2 strength hydrogen peroxide soak 4 swabs
- With a rolling motion gently clean the skin around the trach tube working from the center of the stoma outward
- Use one swab for each quarter around the stoma and under the flange of the tube
- Do not allow any liquid to get into trach tube or stoma area under the tube
- Rinse the area with swab soaked in sterile water
- Pat dry with gauze pad or clean-dry swabs
- Check the skin under the trach ties – wash, dry and cream as needed
- Change the trach ties as required
- Gently tuck gauze around and under the trach tube
- Pre-cut trach gauze is U shaped - if it is not readily available use two weaved-gauze pads – place one under each wing of the tube Be careful that the gauze does not cover the trach tube opening blocking air flow
- Change the dressing when moist to prevent skin irritation
- Monitor skin for signes of infection
Daily use of hydrogen peroxide may cause skin irritation for some patients. Saline wash may be considered a substitution.
Inner cannulas:
· Disposable inner cannulas should be changed and discarded daily.
Reusable cannulas:
· This cannula should be cleaned 1 to 3 times a day - more often if needed.
· Do not leave the inner cannula out for more than 15 minutes as harmful drying of tissue will occur
Supplies
- 1/2 strength hydrogen peroxide
- Sterile water or normal saline
- Two clean disposable cups or sterile containers
- Inner cannula brush (tracheostomy brush or sterile pipe cleaner)
- Medical (unfilled) gauze pad
- Medical moisture barrier pad
Cleaning kits are available for inner cannula trach care. Check with your medical equipmnet supply vendor.
Procedure
- Wash your hands, use sterile gloves - if available
- Lay moisture barrier pad on counter or table top
- Lay supplies on pad
- Pour 1/2 strength hydrogen peroxide into a bowl or cup
- Pour saline or sterile water into the other
- Remove the inner cannula
- Place the inner cannula into 1/2 strength hydrogen peroxide
- Allow it to soak for a few seconds
- Use the brush to clean secretions on the inside and outside of cannula
- Place the cannula into the saline or sterile water solution to soak for a few seconds then rinse
- Dry off excess water with clean lint-free cloth or sterile gauze
- Suction through the outer cannula if needed
- Gently replace inner cannula into the tracheostomy tube
- Be sure the cannula is "locked" in place in the tracheostomy tube
Remove gloves and wash your hands thoroughly.