Tracheostomy Care

General Tracheostomy Information

Inserti
on

Types
of
Tubes
1. Assess Patient and Check Orders
o Assess the need for suctioning
o Assess the need for tracheostomy care
o What trach care is ordered? What to use? How often? Can you change the
ties?

2. Gather Equipment

Tracheostomy Care Kit

 Suction Kit

Sterile disposable inner

cannula

Tracheostomy ties and

dressing as needed

Sterile normal saline, Hydrogen Peroxide, resuscitation bag, 10 ml

syringe, and other supplies as needed
You can get additional information on tracheostomy care and supplies -
See web sites below
3.
4. Insert Oral Airway

Remember that you need to invert the

airway until you get past the tongue and
then flip it over.
5.

6. Administer oxygen via resuscitation bag before and after suctioning

For
tracheostomy
ventilation,
remove the
mask and
attach
directly to
the trach.

Manually
give breaths
to
preoxygenate
the patient
prior to
tracheostomy
suctioning.
7.
8. Do nasopharyngeal suctioning

9. Do oral suctioning

10. Deflate the cuff (must do after oral and nasopharyngeal suctioning

11.
12. Suction the tracheostomy
 Review use of inline suction catheter

Small video: Mac (Quicktime format) and PC

format

13. Remove the inner cannula

This type of inner

cannula twists to unlock
or lock into place

This inner cannula has

clips on each side that
hold it in place
 This cannula has an
end with a tab similar
to the ring on pop
cans. You need to
stabilize the trach
while removing or
inserting inner
cannulas.

14.
15. Insert new or cleaned inner cannula maintaining sterility of cannula

16. Clean around the stoma and trach tube flange using H2O2 and normal saline

Small video: Mac (Quicktime format) and PC format

17. Replace dressing; do not slide over the skin

18. Reinflate the cuff

19. Change trach ties with help

For new tracheostomies, the physician orders when the

ties can be changed in order to prevent accidental removal
of the trach.

Never change ties alone with a new trach.

20.
21. Assess patient response

22. Clean up and replace equipment