How To Clean a Childs Tracheostomy Tube

A tracheostomy tube, or trach tube, allows your child to breathe without using his or her nose or mouth. A trach tube may be made up of one tube called an outer cannula. Or, it may be made up of an outer cannula and a second tube called an inner cannula.

Keeping your child’s trach tube clean helps you prevent infection and helps to make breathing easier.

Supplies needed:

• Suction supplies. These should include a suction catheter.
• Clean medical gloves.
• Sterile trach care kit. The kit should contain:
  • 4 x 4 inch (10 x 10 cm) gauze pads.
  • Cotton-tipped swabs.
  • Trach bandage (gauze dressing or sponge).
  • Two containers or disposable paper cups.
  • Sterile water.
  • 0.9% saline solution.
  • Hydrogen peroxide.
  • Small trach brush or disposable inner cannula.
  • Clean, pre-measured trach tube ties.

How to prepare to clean a trach tube

Choose a time when your child is calm and relaxed. It may help to have another person soothe or distract your child while you clean and change the trach tube.

1. Have all supplies ready and available.
2. Wash your hands with soap and warm water.
3. Put on clean medical gloves.
4. Suction the trach tube as needed.
5. Fill a container or a disposable cup with a solution with equal amounts of hydrogen peroxide and sterile water. This is called hydrogen peroxide solution.
6. Fill another container or disposable cup with only sterile water.
7. Give oxygen as needed.

How to clean a trach tube that has a non-disposable inner cannula

If the inner cannula is removable and non-disposable:

1. Touch only the outer part of the trach tube as you unlock and remove the inner cannula.
2. Put the inner cannula into the hydrogen peroxide solution.
3. Use a small brush to clean the inside and outside of the inner cannula.
4. Rinse the outer cannula with saline solution to remove any dirt, dried mucus, or other debris.
5. Suction the outer tube with the suction catheter.
6. Rinse the inner cannula with sterile water.
7. Pat the inner cannula with gauze to help it get dry.
8. Put the cleaned inner cannula in the trach tube.
9. Lock the cannula into position.
10. Give oxygen as needed.
11. Follow the steps in How to finish cleaning a trach tube.

How to clean a trach tube that has a disposable inner cannula

If the inner cannula is removable and disposable:

1. Remove the new cannula from the packaging.
2. Touch only the outer part of the trach tube as you remove the old inner cannula.
3. Rinse the outer cannula with saline solution to remove any dirt, dried mucus, or other debris.
4. Suction the outer tube with the suction catheter.
5. Put the new inner cannula in the trach tube.
6. Lock the cannula into position.
7. Give oxygen as needed.
8. Throw away the old cannula.
9. Follow the steps in How to finish cleaning a trach tube.

How to finish cleaning a trach tube

1. Soak the cotton-tipped swabs in the hydrogen peroxide solution. Use these swabs to clean the neck plate (flange) and surfaces of the outer cannula. Do not let any solution go into the stoma or trach tube.
2. Remove any wet gauze or bandages from under the flange.
3. Check for signs of infection or skin irritation around the tube or stoma. Check for swelling, redness, warmth, drainage, or tenderness.
4. Use a hydrogen peroxide solution-soaked cotton swab to clean around the stoma in a circular motion. Start from the opening and go outward. If the hydrogen peroxide solution irritates the skin, use only sterile water.
5. Dry the skin and the outer cannula by gently patting the area with a dry gauze pad.
6. Replace trach gauze, as needed.
7. Secure the trach tube with trach ties.
8. Place a dressing around the trach site.
9. Give oxygen as needed.
10. Throw away any used supplies.
11. Remove your gloves.
12. Wash your hands with soap and warm water.

Contact a health care provider if:

• You have any problems cleaning your child’s trach tube.
• You notice swelling, redness, warmth, drainage, or tenderness around your child’s stoma.
• Your child has a small amount of bleeding around the stoma.
• Your child has a fever.

Get help right away if:

• You child cannot breathe, even after you do suctioning and cleaning.
• Your child’s trach tube falls out and cannot be put back in.
• Your child’s trach tube becomes blocked and you cannot unblock it.
• Your child is bleeding heavily from the stoma or trach area.
• Your child has bright red mucus.

Summary

• A tracheostomy tube, or trach tube, allows your child to breathe without using his or her nose or mouth.
• A trach tube may be made up of one tube called an outer cannula. Or, it may be made up of an outer cannula and a second tube called an inner cannula.
• Keeping your child’s trach tube clean helps you prevent infection and makes breathing easier.
• While cleaning your child’s trach tube, check for signs of infection or skin irritation around the tube or stoma.