Tracheostomy Care

You need to take care of your trach tube, your stoma, and the skin around the stoma. You will be told by your healthcare team how to do this. Check that you have been given a home care instruction manual for tracheostomy before discharge. Make sure you have contact information for an equipment supply company and a checklist of emergency supplies before discharge. The guidelines below may also help you.

Keeping the tracheostomy clean

To take care of your skin and prevent infection, you need to keep your tracheostomy clean. You will be shown how to do this. Clean the tracheostomy at least once a day. Clean more often, if you need to.

Keeping your trach ties clean

Trach ties fit around your neck to hold your tube in place. They will get dirty. Plastic ties can be wiped clean. Fabric ties need to be changed when they are dirty. You will be shown the best way to change your ties.

Close-up of neck with trach tube and two fingers under ties.
Trach ties fit right if you can put two fingers between the ties and your neck.

Keeping the trach tube clear

There is always some mucus in your airway. But mucus can build up and thicken. If this happens, your trach tube can become plugged. To keep the trach tube clear of mucus buildup, you may need to do one or more of the following:

  • Suction the mucus out of the airway. To do this, you use a special machine. You will be told how to suction and how often.

  • Moisten the air you breathe. Normally, the nose moistens air as it's breathed in. With a tracheostomy, you need another way to moisten the air, such as using a humidifier. Ask your healthcare provider what method of moistening the air you should use.

  • Don't wear clothing that covers the opening of the trach tube. Examples can include turtleneck shirts and tightly wrapped scarves.

You will be told ahead of time what to do if your tube becomes plugged. If you ever have trouble breathing, call 911 right away.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these problems:

  • Red, painful, or bleeding stoma

  • Swelling around the trach tube

  • Fever of 100.4°F ( 38°C) or higher, or as directed by your healthcare provider

  • Yellow, foul-smelling, bloody, or thick mucus

  • Vomiting that doesn’t go away

  • Coughing up blood, or a lot of bleeding from the tracheostomy site

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