Health Library

Discharge Instructions: Caring for Your Tracheostomy Tube and Stoma

You have had surgery to create an opening through your neck and into your trachea. A tube (cannula) was inserted into the opening to allow you to breathe. You need to take care of your tracheostomy (“trach”) tube, your stoma (the opening in your neck), and the skin around the stoma. Your healthcare team will teach you how to do this. The guidelines below will also help.

Cleaning Your Trach Tube and Stoma

Clean your tube and the skin around it at least once a day. Follow these steps and any other guidelines you have been given. Choose a clean, well-lighted space near a sink and mirror.

Step 1

• Collect the following supplies:

  • Lint-free bandages

  • Cotton swabs

  • Trach tube brush

  • Bowl filled with equal parts of distilled water and hydrogen peroxide

• Wash your hands with soap and warm water. Put on clean, disposable, powderless gloves.

Step 2

• Remove the inner cannula (tube).

  • Hold the neck plate with one hand. With the other hand, unlock the inner cannula. Gently remove the inner cannula.

  • Don’t remove the outer cannula (tube).

Step 3

• Clean the inner cannula.

  • Soak the inner cannula in the bowl of distilled water and hydrogen peroxide.

  • Clean the inner cannula with a trach tube brush. Don’t use a toothbrush. Rinse with distilled water.

  • Put the wet inner cannula back into the outer cannula. Lock the inner cannula in place.

Step 4

• Clean your neck plate and skin.

  • Remove the soiled gauze, if used, from behind the neck plate. Clean the neck plate and the skin under it. Use a clean gauze pad or a cotton swab dabbed in distilled water. Gently pat the skin dry.

  • Put a clean, precut gauze pad under the neck plate. This pad protects your skin.

If Your Trach Tube Becomes Plugged

It is normal to have some mucus in your airway, but mucus can build up and thicken. If this happens, your trach tube can become plugged. Follow these steps and any other guidelines you have been given to clear your trach tube.

• Find a clean, well-lighted space near a sink and mirror.

• Collect the following supplies:

  • Suction machine

  • Clean suction catheter (tube)

  • Small bowl of distilled water

• Wash your hands with soap and warm water. Then put on clean, disposable, powderless gloves.

• Prepare to suction:

  • Turn on the suction machine to _____ mm Hg. (Use the setting you were given by your healthcare provider.)

  • Attach the suction catheter to the suction machine. Ensure the suction is working: dip the catheter tip into the distilled water.

• Insert the catheter into your trach tube:

  • Take a few deep breaths to fill your lungs with oxygen.

  • Gently insert the catheter into your trach tube. While you are inserting the catheter, don’t suction. Stop inserting the catheter when you start to cough.

• Suction:

  • Apply suction. At the same time, slowly pull the catheter out of your trach tube. Move the catheter tip in a circle as you pull the catheter out.

  • Take 5 to 10 seconds to remove the catheter completely from your trach tube. If you need to suction more, relax and breathe for a few minutes before you start again.

• When you are finished, turn off the suction machine. Discard the used catheter, water, and gloves.

Follow-Up

Make a follow-up appointment as directed by our staff.

When to Call Your Doctor

Call your doctor right away if you have any of the following:

• Shortness of breath, wheezing, or coughing

• Red, painful, or bleeding stoma

• Swelling around the trach tube

• Fever of 100.4°F or higher, or chills

• Yellow, smelly, bloody, or thick mucus

• Vomiting that doesn’t go away

Note: If you ever have trouble breathing, call 911 (emergency) right away.