How to Care for a Tracheostomy. A tracheostomy (trach) is an opening into the windpipe to supply air. This is often done temporarily for emergency reasons, but many times, a tracheostomy is left in permanently. A trach requires special care. The patient and his family will be taught to care for the tracheostomy before leaving the hospital. Here is how to care for a tracheostomy.
Daily Tracheostomy Maintenance
Understand the anatomy of a trach tube. The trach tube has three parts; the obturator, the outer cannula with trach plate and the inner cannula. The obturator is used to pass the trach tube into the windpipe. When the obturator is removed, an outer tube (cannula) remains. This outer cannula has a plastic trach plate that fits against the skin on the neck and holds the trach in place. The trach plate is held in place with trach ties. Then there's an inner cannula that fits inside the outer one and locks into place.
Maintain the inner cannula by changing and cleaning it daily.
Wash hands with soap and water then put on latex gloves. Gently unlock the inner cannula and remove it by pulling it gently out and down and set it aside to clean later.
Put a clean, wet cannula inside the outer cannula and lock it in place.
Place a clean gauze pad gently under the trach plate to catch secretions. There are gauze pads made specifically to go under trach plates.
Change the trach ties if necessary and tie securely.
Clean the Inner Cannula
Soak the dirty cannula in liquid soap and water.
Scrub it inside and out with a small trach brush and rinse it well.
Place it in a solution of 1/2 peroxide and 1/2 water and let it bubble.
Clean it inside and out again with a clean brush after the bubbling stops. Rinse it well under running water.
Allow it to air dry and keep it for the next trach change.