How to Clean a Tracheostomy and Replace Tracheostomy Ties

How to Clean a Tracheostomy and Replace Tracheostomy Ties

A tracheostomy is a surgically created opening in the trachea that is made in the front of the neck. It is important to keep a tracheostomy clean. Doing this helps you:

  • Keep your skin healthy.
  • Reduce your risk of infection.
  • Keep your airway secure.

Make sure to follow any specific instructions from the person’s health care provider when you clean a tracheostomy and replace tracheostomy ties or a holder.

Tips

  • If available, have a second person helping you (helper).
  • If tracheostomy ties are used, it is important to replace them regularly to keep them from getting damaged or dirty.

How to get ready

  1. Have all supplies ready and available. These include:
    1. Clean gloves.
    1. Twill tape (ties) or a manufactured tracheostomy holder.
    1. Scissors.
    1. Container to hold liquid.
    1. Sterile water, tap water, or 0.9% saline solution.
    1. Rolled-up blanket or towel.
    1. Sponge.
    1. Cotton swabs.
    1. 4×4 inch (10×10 cm) gauze pads.
    1. Pre-cut pads or gauze for under the faceplate.
    1. Clamp or tweezers.
  2. Wash your hands, and have your helper wash his or her hands.
  3. Put on clean gloves, and have your helper put on clean gloves.
  4. If using tracheostomy ties:
    1. Measure a length of twill tie that can go around the neck twice.
    1. Cut the end of the tie on a diagonal to a point. This will make it easier to thread through the opening of the faceplate.
  5. If using a tracheostomy holder, open the packaging.

How to clean the tracheostomy

  1. Fill a container with the water or 0.9% saline solution.
  2. Have the person tip his or her head back a little. This will make it easier to see and clean the opening in his or her neck.
  3. Place a rolled-up blanket or towel under or behind the person’s shoulders.
  4. If there are any pads under the faceplate, remove them.
  5. Wet the sponge and cotton swabs with the water or 0.9% saline solution.
  6. Clean the tracheostomy site, surrounding skin, and neck.
  7. Allow the skin to dry. You may pat it dry with a dry 4×4 inch (10×10 cm) gauze.
  8. Replace the tracheostomy pads with a pre-cut pad or gauze.

How to replace the ties or holder

If Tracheostomy Ties Are Used

Follow these steps to replace them:

  1. While you hold the tracheostomy tube—also called a trach (rhymes with “take”)—have your helper cut or loosen the ties that are in place. Make sure the tube (trach) stays in place until the new ties are secured. (If working alone, do not remove the old ties until the new ties are secured.)
  2. Use a clamp or tweezers, if needed, to thread one end of the new tie through the faceplate or trach flange. Pull through until the ends are even.
  3. Bring ties around the back of the neck, then thread one tie through the opposite hole in the faceplate.
  4. Gently pull the ties to secure the trach.
  5. Secure the tie with a double square knot. For comfort, make sure you can fit 1–2 finger widths between the neck and the tie.

If a Tracheostomy Holder Is Used

Have one person hold the trach while the other person changes the holder. Make sure the trach stays in place until the new ties are secured. (If working alone, apply and secure the new holder before you remove the dirty holder.)

Follow these steps to replace the holder:

  1. Position the strap around the back of the neck.
  2. Slide the narrow ends under and through the faceplate.
  3. Gently pull the ends of the strap so they are tight and secured. For comfort, make sure you can fit 1–2 finger widths between the neck and the strap.

How to finish the process

  1. Throw away any used supplies.
  2. Remove your gloves, and have your helper remove his or her gloves.
  3. Wash your hands, and have your helper wash his or her hands.
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