Trach 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 the images below for more information on each topic. 

Emergency Equipment

Make sure equipment is close to the bedside and during transportation in case of emergency.

tracheostomy tube cuff deflated

Routine Tracheostomy Tube Changes

Information about routine tracheostomy tube changes as well as learning signs of emergent tracheostomy tube changes.

Stoma care

Stoma Care

Cleaning and caring for the stoma reduces the risk of infection.

tracheostomy cuff

Cuff Management

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

tracheostomy suctioning

Secretion Management

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.

inner cannula of a tracheostomy tube

Cleaning and Replacing the Inner Cannula

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

CPR for the patient with tracheostomy

coming soon

Resources:

Garrubba, M, Turner, T, Grieveson, C. Multidisciplinary care for tracheostomy patients: a systematic review. Crit Care. 2009;13:R177.
Google Scholar | Medline | ISI

Cetto, R, Arora, A, Hettige, R. Improving tracheostomy care: a prospective study of the multidisciplinary approach. Clin Otolaryngol. 2011;36:482-488.
Google Scholar | Medline | ISI

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.
Google Scholar | Medline | ISI

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.
Google Scholar | Medline | ISI