Tracheostomy Care

Understanding how to care for the tracheostomy tube is vital in reducing infection and mortality rates. There is evidence that a multidisciplinary approach and use of a tracheostomy care protocol leads to decreased mobidity and mortality as well as reduced average time to decannulation (Garrubba et al., 2009; Cetto & Hettige, 2011; Hettige et al., 2008; Arora et al., 2008).  The care provider of individuals with tracheostomy should have knowledge of emergency equipment, tracheostomy tube changes, stoma care, secretion management (including suctioning, humidification, tracheostomy occlusion, cough techniques and expiratory muscle strength training), and cleaning and replacing the inner cannula. 

Click below for more information on each topic. 

Managing the tracheostomy cuff is important for preventing complications of cuff overinflation or underinflation.

A tracheostomy tube results impaired secretion management. Learn about suctioning, maintaining appropriate humidification, physical mobilization, cough techniques, clearing secretions with occlusion of the tracheostomy, and expiratory muscle strength training.

Regular clearning or replacement of the inner cannula can prevent tube obstruction.

Garrubba, M, Turner, T, Grieveson, C. Multidisciplinary care for tracheostomy patients: a systematic review. Crit Care. 2009;13:R177.
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Cetto, R, Arora, A, Hettige, R. Improving tracheostomy care: a prospective study of the multidisciplinary approach. Clin Otolaryngol. 2011;36:482-488.
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Hettige, R, Arora, A, Ifeacho, S, Narula, A. Improving tracheostomy management through design, implementation and prospective audit of a care bundle: how we do it. Clin Otolaryngol. 2008;33:488-491.
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Arora, A, Hettige, R, Ifeacho, S, Narula, A. Driving standards in tracheostomy care: a preliminary communication of the St Mary’s ENT-led multi disciplinary team approach. Clin Otolaryngol. 2008;33:596-599.
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