Tracheostomy Tube Care Steps

A tracheostomy, or trach (rhymes with “take”), is a surgically created opening in the trachea. A tracheostomy tube, or trach tube, is a tube that is placed in this opening to help with breathing. Taking good care of your trach and trach tube will help you stay safe and free from infection.

What safety actions should I take?

General Instructions

• Follow instructions from your health care provider about:
  • Cleaning your trach and the area around it.
  • Suctioning your trach.
  • Cleaning your trach tube.
  • Changing your trach tube.
• Keep your trach and trach tube dry. When you take a shower:
  • Cover your trach with a shower shield or other protective covering.
  • Try not to point the shower spray at your trach.
• Keep clothing away from your trach tube. Clothing can block the tube. When dressing:
  • Avoid wearing crew-neck shirts and turtlenecks.
  • Wear V -neck shirts and open-collar shirts or blouses.
  • You may wear a scarf over the trach tube.
  • Do not wear clothes that shed fibers or lint.
• Do not put anything in your trach tube that should not be there.
• Use a humidifier to keep some moisture in the air. This will keep your airway and lungs from getting dry. Clean the humidifier regularly to prevent mold and mildew from building up.
• Avoid dust, mold, smoke, and fumes from cleaning solutions, such as ammonia or bleach.
• When you use any kind of spray or powder, cover your trach tube. Do not inhale the spray or powder.

Before You Leave Home:

• (If it is cold outside) Wear a filter to keep cold air from entering your trach tube and irritating your trachea and lungs. You can also loosely cover your trach tube with a protective scarf, handkerchief, or gauze. Wearing a scarf helps to warm the air as you breathe.
• (If it is windy) Consider covering your trach tube with a scarf. This will help to keep dust or dirt from getting into your tube.
• Always carry your emergency travel kit with you when you leave the house. Your kit should include:
  • A portable suction machine.
  • Suction catheters.
  • A mucus trap.
  • A bulb syringe.
  • Two trach tubes. One should be the same size as your current tube, and the other should be smaller.
  • Trach ties.
  • A heat and moisture exchanger.
  • Emergency phone numbers.
  • Sterile water.
  • 0.9% saline solution.
  • Sterile gloves or hand sanitizer.
  • Sterile gauze pads.

If You Get Sick:

• Suction your trach more often.
• Do these things if you vomit:
  • Cover your trach tube with a towel to keep vomit out of your airway.
  • Suction right away if you think vomit may have gotten into your trach tube.

If You Use a Ventilator:

• Check the ventilator safety and sound alarms every day to be sure they work.
• Make sure the ventilator tubes are in the right place and do not pull on the trach tube.
• Do not twist or pull on the trach connector more than needed. Too much pulling or twisting can cause the ventilator tubes to disconnect.
• Hold the trach tube in place while you hook up or disconnect the ventilator or humidification tubing.
• Always use an inner cannula without side openings (non-fenestrated cannula) with the correct connector if you are using a trach tube that has one or more side openings (fenestrated trach tube).

Contact a health care provider if:

• You cannot remove your trach tube or inner cannula.
• You have redness, swelling, or tenderness around your trach.
• You have fluid or blood coming from your trach.
• Your trach feels warm to the touch.
• You have pus or a bad smell coming from your trach.
• You have a fever or chills.
• Your muscles ache.
• You have a cough that gets worse.

Get help right away if:

• You have chest pain or trouble breathing, even after you suction and clean your trach tube.
• You have a fever for more than 2–3 days.
• You have nausea and vomiting.
• You feel dizzy or you faint.
• You have trouble swallowing.
• You have unusual sounds coming from the airway.
• You continue to cough or have shortness of breath after suctioning.
• There is bright red blood in your mucus.
• Your tube gets plugged and you cannot clear it.
• Your tube falls out and cannot be put back in.