Caring for your tracheostomy: A guide

Oct 20, 2023

Caring for a tracheostomy can involve suctioning mucus and secretions from the tracheostomy; cleaning the tracheostomy site, cannulas, and suction catheter; replacing the cannula; and humidifying the air.

A tracheostomy is a procedure in which a healthcare professional creates an opening in the trachea, which is the windpipe in the front of the neck, and inserts a tube into the opening to help a person breathe.

This article looks at tracheostomy care in the hospital, routine elements of tracheostomy care, and how a person can care for their tracheostomy at home. It also discusses living with a tracheostomy and when to contact healthcare professionals for help.

While a person is in the hospital, healthcare professionals will care for the tracheostomy.

If a person has a temporary or permanent tracheostomy, they will need to know how to care for it after they leave the hospital. A healthcare professional will provide training on how to do this.

Healthcare professionals will instruct a person on how to:

Healthcare professionals will also instruct a person on living with a tracheostomy, such as how to eat, how to engage in physical activity, and what to do in an emergency.

A person will need to do the following every day to ensure that the tracheostomy site and tube are clean. How a person keeps the tracheostomy tube clean can depend on the type of tube they have.

Individuals should ensure that the stoma site is always clean and dry. A person should inspect the tracheostomy site regularly for signs of irritation and infection, such as:

A person should clean the skin around the tracheostomy 2–3 times per day with cotton swabs or gauze pads and saline or sterile water.

They should gently wipe away any dried secretions and excess moisture in the area.

A speaking valve is a one-way valve that fits onto a tracheostomy to allow air to enter through the tube and exit through the nose and mouth. The valve can help a person speak and make noise more easily.

A person can clean a speaking valve by following these steps:

Using a humidifier is important because it can help keep the secretions loose so the tracheostomy tube does not become clogged.

A person can use a humidifier to moisten the air or hang a clean, moistened piece of gauze in front of the tracheostomy opening.

The number of times a person will need to suction the tracheostomy in a day can differ between individuals.

A person may need to suction a recent tracheostomy more often. Also, people may experience more secretions and mucus on some days than on others, which could lead to more frequent suction.

To suction the tracheostomy tube, a person will need to:

A person may need to change the tracheostomy tube every 1–3 months. A healthcare professional will instruct a person on how to change the tube, depending on its type.

A person may need to change their inner cannula two times per day, or more often if secretions build up inside it. Typically, a person should change their cannula once in the morning and once at night.

To change the cannula, a person should:

If a person is not using disposable cannulas, they should clean the used cannula once they have replaced it.

A person should clean a reusable cannula according to the manufacturer’s directions, which may instruct a person to clean with saline solution alone or with a mixture of sterile water and diluted hydrogen peroxide.

Tracheostomy ties go around a person’s neck and secure the tracheostomy tubes in place.

A person should change the ties as needed if they become visibly dirty, if they become loose, or if they use Velcro that is no longer effective. There are different types of tracheostomy ties, and a person may need help replacing them.

A person should put the new tie through both sides of the neck plate and fasten it at the back of the neck, either with a knot or with Velcro, and then remove the old ties. There should be enough room for a person to put a finger beneath the ties.

Individuals should ensure that the new ties secure the tracheostomy tube in place before they remove the old ties.

A person should discuss aspects of living with a tracheostomy with their healthcare team. Issues may include:

If a person has suctioned the tracheostomy and still cannot breathe, they or someone else should call 911.

If the tracheostomy tube comes out, a person should not panic, as they can breathe through the stoma. To replace the tube, a person should:

A person may wish to contact a doctor once they have replaced the tube. If a person is unable to replace the tube or has difficulty breathing, they should call 911.

If a person has symptoms of infection, they should contact a doctor. These include:

Healthcare professionals will instruct a person on how to care for a tracheostomy before they leave the hospital.

Healthcare professionals will also teach a person how to use all the necessary equipment, such as a suctioning machine; how to handle lifestyle changes such as bathing and eating; and how to handle emergencies.