Supplies

• 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 cupsSterile gloves if available
• Medical moisture barrier pad

 

Procedure

• Wash your hands - sterile gloves recommended
• Lay moisture barrier pad (medical pad) on a counter or table top Lay supplies on padPour 1/2 strength hydrogen peroxide into one cup and sterile water into the otherIn 1/2 strength hydrogen peroxide soak 4 swabsWith a rolling motion gently clean the skin around the trach tube working from the center of the stoma outwardUse one swab for each quarter around the stoma and under the flange of the tubeDo not allow any liquid to get into trach tube or stoma area under the tubeRinse the area with swab soaked in sterile water Pat dry with gauze pad or clean-dry swabsCheck the skin under the trach ties – wash, dry and cream as neededChange 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 tubeBe 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 signs of infection
• If stoma area becomes red, swollen, inflamed, warm to touch or has a foul odor, call your doctor Before applying any ointments near the tracheostomy call your doctorIf an antibiotic or anti fungal ointment is prescribed by the doctor, gently apply a thin layer with a cotton swab
• When applying prescribed ointments apply away from the trach stoma

 

Note: It is recommended you speak to your physician or respiratory specialist.Daily use of hydrogen peroxide may cause skin irritation for some patients. Saline wash may be considered a substitution.

 

INNER CANNULA CARE

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 tissue-drying could 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
  
  Note: Cleaning kits are available for inner cannula trach care. Check with your 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 to soak it 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