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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Ear Nose and Throat

Tracheostomy Care at Home (5340)

Tracheostomy Care at Home (5340) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Ear Nose and Throat

5340








Tracheostomy Care at Home

This handout will cover routine
tracheostomy (trach) care that should be
done by those who have a trach tube in place
or a stoma present.

Irrigation

You will need to clear your trach tube or
stoma every day. This is called irrigating. It
is done to help you keep your airway clear.
Do this three times a day or more if needed.
Do it when you feel that your airway is
partly blocked or full of mucus. Doing this
three times a day every day will keep your
trachea moist and free from crust.

Trach Care With a Trach Tube in Place

1. Wash your hands before starting.

2. Draw up 3-5 mL of saline in your
syringe and set aside.

3. Pour a small amount normal saline and
the same amount of hydrogen peroxide
into the container of your trach care kit.

4. Remove the inner cannula and place it in
the solution of equal parts of normal
saline hydrogen peroxide to soak. You
must remove the inner cannula before
irrigating to prevent mucus within the
cannula from being pushed back into
your lungs.

5. Take 2 slow, deep breaths in and out.
On the third deep breath, inject the
syringe of saline into your trachea. This
will make you cough up mucus through
your trach. Make sure you have your
Kleenex® ready in one hand.

6. Repeat these steps a second time. Even
if you feel that you have cleared the
mucus the first time, irrigate a second
time. After the second time, if you still
feel like you can’t clear the mucus, you
keep irrigating until you feel clear.

7. With the brush supplied in the kit, clean
out the inner cannula. Rinse it well with
running tap water. If you have no water,
use saline.

8. Shake the excess water off the inner
cannula or use pipe cleaners to soak up
the water.

9. Replace the inner cannula into the trach
tube and lock it in place.

10. Change the trach ties as needed when
they get dirty. You may need someone’s
help with this.

11. After irrigating you will need to do trach
site care, (see below).






Trach Care Without a Trach Tube in
Place

1. Wash your hands before starting your
care.

2. Draw up 3-5 mL of saline in your
syringe and set aside.

3. Take 2 slow deep breaths in and out. On
the third deep breath in, inject the
syringe of saline into your trachea
(stoma). This will make you cough up
mucus through your stoma.

4. Repeat these steps a second time. Even
if you feel that you have cleared the
mucus the first time, irrigate a second
time. After the second time, if you still
feel like you can’t clear the mucus, keep
irrigating until you feel clear.

Trach/Stoma Site Care

Be sure to make site care a part of your
routine every time you clean your trach or
stoma. Cleaning around your trach tube or
stoma is the best way to prevent skin
breakdown. Clean around the area with
cotton-tipped swabs using mild soap and
water or saline, if you have no soap and
water. You can also use a washcloth. Make
sure that it is clean and that you are able to
reach under the faceplate of the trach tube, if
you have one in place. If your nurse told
you to use a gauze dressing around your
trach tube, change it when you do site care
or when it is soiled.

1. To make your own saline: Add 2
teaspoons of table salt to 1 quart of cool
water that has been boiled for 3 minutes.

2. After being opened, saline may be kept
in the refrigerator for 1 week. Date your
bottle and discard it after 1 week.

3. Wash syringes, trach brush, cleaning
trays, and containers with hot soapy
water and rinse well after use. Use new
items as needed.

4. Protect your stoma or trach with trach
bibs to keep foreign material from being
breathed into your lungs. This is very
important when you are outside or taking
a shower.

5. Irrigate more often if you get a cold to
keep the mucus thin enough and easy to
cough up.

6. If you have a trach tube in place and you
can’t clear the mucus when taking the
inner cannula out and irrigating, remove
the entire trach tube and clean it.

7. If you have a trach tube and it must be
taken out or it slips out of place by
mistake, remove your inner cannula and
insert your obturator. Place the trach
tube with the obturator into your neck
opening and fasten the ties. Remove the
obturator and insert the inner cannula.
The mucus may be blood-tinged for a
day or two due to tissue irritation.

8. Humidity is a must. The air you
breathe will no longer pass through the
nasal passages which normally moisten
the air and prevent mucous plugs from
forming. Place a humidifier by your bed
at night. Controlled humidity in the rest
of the house is also helpful. Use of
humidity is most important during the
first month after surgery. You may also
need to use more humidity during the
winter.





When to Call Your Doctor

Please report any of these symptoms.

 Any pus-like, or increased drainage
 Increased redness around the trach
site
 Pain that doesn’t get better with
medicine
 Foul smelling drainage
 Temperature of 100.5 θ F (38.5 θ C)
 Any breakdown of skin around the
trach, stoma, or suture lines
 Any airway problems after putting
your trach tube in with the obturator




If you have any questions or problems once
you are home, please call:

ENT Clinic, Monday-Friday 8:00 am to 5:00
pm, at (608) 263-6190

After 5:00 pm, weekends or holidays, this
number will be answered by the paging
operator. Ask for the ENT doctor on call.
Leave your name, area code, and phone
number. The doctor will call you back.

If you live out of the area, please call
1-800-323-8942.























Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 9/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5340.