Home Guide for Tracheostomy Management
A tracheostomy, a hole made in the throat by surgeons to aid breathing, requires careful home care to ensure airway patency, prevent infection, and promote comfort and safety for the individual. Here's a step-by-step guide to help you manage tracheostomy care at home.
Clean the inner cannula daily
Remove the inner cannula carefully and clean it inside and outside with hydrogen peroxide and a soft brush or pipe cleaner. Rinse it with sterile saline and replace it. If the cannula cannot be cleaned well, replace it with a new one [1][5].
Suction the tracheostomy tube as needed
Use appropriate suction equipment and hygiene measures such as gloves and hand washing to remove secretions and maintain an open airway. Dr. Tierney recommends suctioning at least three times per day, depending on individual needs [3].
Check cuff pressure daily
If the tube has a cuff, ensure it contains the correct amount of air, which prevents airway damage and breathing problems [1][3].
Keep the stoma clean and dry
Clean around the stoma daily using normal saline or betadine followed by saline-soaked gauze. Check for signs of infection like redness, crusting, or discharge. Change dressings daily or as needed [3][5].
Monitor skin around the stoma for pressure damage
Ensure ties or straps are snug but not too tight—loosely enough to fit one finger between skin and tie. Check for signs of pressure damage from the tube flange [5].
Maintain good oral hygiene
Brush teeth twice daily and rinse after meals to reduce infection risk [5].
Protect the tracheostomy tube from water exposure
Use shower shields or covers during bathing, and avoid swimming to prevent water from entering the airway [1].
Keep all tracheostomy equipment clean
Wash hands or use gloves before handling, and maintain suctioning equipment hygiene [2][3].
Other important considerations
- Use a tracheostomy emergency kit at home, with supplies checked regularly [3].
- Humidify the airway, especially if humidification devices are part of the setup, to prevent thick mucus and blockage [3].
- Establish a non-verbal communication system if speaking is difficult [3][4].
Equipment needed
Inner and outer cannulas, a suction machine, tracheostomy ties, padding, and a split gauze are typical supplies needed for tracheostomy care [1][4]. It's best to source these supplies from a medical supply company specializing in respiratory care.
Precautions
Suctioning too much can irritate the airway, leading to bleeding or extra mucus. Suctioning too little can lead to more frequent mucus blockages in the inner cannulas. Inner cannulas need to be replaced daily, while reusable ones should be cleaned at least daily [1][3].
Safety measures
Tracheostomy care can be done safely at home with the help of loved ones or caregivers. However, if symptoms worsen, call the surgeon immediately [1].
Personal factors
Tracheostomy care often depends on personal factors and the reason for the tracheostomy [3]. Always follow the specific instructions provided by the healthcare team and seek their guidance for any concerns or emergencies.
- Adhering to a regular skin-care routine is essential for individuals with a tracheostomy to prevent infection around the stoma.
- Mental health is equally important for those living with a tracheostomy, and establishing non-verbal communication methods can help reduce feelings of isolation and frustration.
- Fitness and exercise, like regular walking or breathing exercises, can help improve overall health and wellness for individuals with chronic diseases such as chronic kidney disease or respiratory conditions.
- Therapies and treatments like CBD oil might provide additional relief for individuals with chronic diseases, especially if they are experiencing anxiety or inflammation.
- Proper hygiene, including maintaining good oral hygiene and keeping all tracheostomy equipment clean, will help prevent infections and ensure the safe and effective functioning of the tracheostomy.
- When managing tracheostomy care at home, it's recommended to consult with mental health professionals for additional support and guidance in dealing with the emotional challenges associated with living with a tracheostomy.
