TRACHEOTOMY CARE

Published: June 3, 2006
116

Caring for your Tracheotomy

Preventing Water from Entering Tracheotomy – Following are some of the ways you can prevent water from entering your tracheotomy:

* Do not swim
* When showering: direct the water spray at chest level, and place the shower shield over your tracheotomy or hold a dry washcloth in your teeth.
* Keep soap and water from entering your tracheotomy when washing your face
* Use care when powders, after shave, or aerosols are directed toward your face
* Avoid contact with people with respiratory infections (colds)

Suctioning – The following equipment is needed for suctioning your tracheotomy tube.

* Sterile suction kit
* Normal saline solution
* Suction machine
* Ambu-bag

Following is the procedure for suctioning:

* Wash your hands, and then open the sterile suction kit
* Put on the sterile gloves. Keep your dominant hand “sterile” by making sure you do not touch the outside of the glove that is going on your dominant hand.
* Using your dominant “sterile” hand, attach the sterile suction Catheter to the suction tubing which you will hold in your non-dominant “dirty” hand.
* Using your non-dominant “dirty” hand, attach the ambu-bag to the tracheotomy tube and give 3-5 “deep breaths”.
* Remove the ambu-bag from the tracheotomy tube. With your dominant “sterile” hand, insert the suction catheter into the tracheotomy tube, keeping your non-dominant thumb off the suction port. Insert the catheter as far as it will go without using force.
* Place your non-dominant “dirty” thumb over the suction port to produce suction. Rotate the catheter between your dominant “sterile” thumb and forefinger, gradually withdrawing the catheter. As you withdraw the catheter from the tracheotomy tube, apply intermittent suction by moving your non-dominant “dirty” thumb up and down on the suction port. Do not suction for longer than 10-15 seconds.
* Flush the suction catheter with the sterile solution in the suction kit.
* Again, attach the ambu-bag to the tracheotomy tube and, using your non-dominant “dirty” hand, give 3-5 deep breaths.

If secretions are thick, squeeze normal saline into the tracheotomy tube. With your non-dominant “dirty” hand, use the ambu-bag to give deep breaths and then repeat the suction technique. This will help “thin” secretions.

You may suction your mouth after your tracheotomy tube has been suctioned. Never suction your mouth and then your tracheotomy.

Cleaning the Suction Catheter – Suction catheters must be cleaned after each use to keep to prevent putting bacteria into your tracheotomy when you use the catheter. The following equipment is needed to clean the suction catheter:

* Soap
* Tap water
* Cooled boiled water
* Bulb syringe
* Dry, clean towel or handi-wipe

Following is the procedure for cleaning the suction catheter:

* Wash the suction catheter with soap and water, using the bulb syringe to force soapy water and rinse water through the catheter
* Rinse catheter in boiled water
* Dry catheter with lint-free cloth or handi-wipe
* Store catheter in a dry towel or in a clean baggie (several catheters can be stored together)

Throw catheter away if secretions cannot be removed, or if catheter becomes cloudy or cracks.

Cleaning the inner cannula – The inner, removable tube of the tracheotomy tube is the inner cannula. Secretions must be removed from the inner cannula to keep the tracheotomy tube open. Following is the procedure for cleaning the inner cannula tube:

* Wash your hands
* Gently remove the inner cannula
* Wash with mild soap and tap water; rinse very well in boiled water. If secretions are hard to remove, soak in Hydrogen Peroxide or normal saline; use a small percolator brush to clean secretions from the inside of the inner cannula
* Suction through the outer cannula
* Shake excess moisture from the inner cannula, removing lint.
* Grasp the collar of the outer cannula and insert inner cannula; lock in place
* Wash skin around the tracheotomy with soap and water; rinse well with tap water and dry with a clean cloth
* If there are secretions around the tracheotomy tube, apply folded 4″ x 4″ dressing

Tracheotomy with Dressing
Tracheotomy with Dressing
The inner cannula needs to be cleaned at least once a day (cleaning every 8 hours is best). Skin around the tracheotomy can also be cleaned at the same time. Do not leave a regular inner cannula out more than 10-15 minutes while cleaning. Inner cannula can be stored in a clean jar with a lid.

Cleaning connecting tubes on suction machine – These tubes must be cleaned to prevent too many bacteria from getting into the suction equipment. Clean daily with soap and water; rinse well with hot water.

Cleaning drainage bottle – The drainage bottle must be emptied once a day. Clean it with soapy water and rinse it well with hot water.

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