Tracheostomy tube care

Management of secretions:

• Cough out the sputum or secretion when you feel sensation of obstruction in the airway

• If available suction has to be kept bedside and suction can be done 3 or 4 times a day or more if needed, do it before bedtime & when you wake up in morning.

• Use appropriate size catheter for suctioning.

• The inner cannula is to be removed at the time of suctioning and the cannula is to be cleaned in running water and the brush provided.

• Suction to be applied while withdrawing the catheter, never more than 10 seconds at a time.

• Do not suction or do any tracheostomy care after eating unless very necessary.

Stoma care:

• Clean the stoma 3 times a day.

• You can take bath preferably below the neck by covering the stoma with a cloth.

• Stoma site is to be kept clean at all times.

• A gauze is to be placed between the tracheostomy tube and the skin. 

• You can wear any kind of clothes that are loose around the neck.

• Change the tie around the neck when it is wet, dirty or frayed.

Cuff inflation(if cuff is present):

• Cuff to be inflated with 5-8 cc of air, if you're advised to do so.

• Cuff to be deflated every 2 hrs for 5 minutes & reinflated if you're advised.

• Cuff to be kept inflated during feeding and for 30 minutes after.

Humidifying the air:

• Provide humidity, moisture in the inspired air by placing wet gauze soaked in saline over the stomal opening.

• Steaming kettle can be kept nearby to maintain the humidity of the inspired air. 

General measures:

• Always wash your hands before and after handling the tracheostomy tube

• Always keep a calling bell or alarm beside.

• Always carry paper and pen to communicate.

• Avoid sitting or sleeping directly under the fan.

• Follow breathing exercise (deep inspiration & expiration) & breath holding.

• Visit regularly treating doctor regularly atleast once in a month for follow up.