2-40. PERFORMING TRACHEOSTOMY CARE
Changing the tracheostomy dressing, cleansing the skin around the stoma, and
cleaning the inner cannula are collectively referred to as tracheostomy care.
a. Assemble necessary equipment and supplies.
Trach cleaning kit (obtain from CMS).
Sterile saline--pour bottle.
Sterile gloves--2 pairs.
b. Explain the procedure to the patient and establish a method of
c. If suctioning is required, perform that procedure prior to beginning
tracheostomy care. It is routine to perform tracheostomy care after suctioning.
d. Position the patient in semi-Fowler's position if permissible.
e. Wash your hands and set up the equipment using aseptic technique.
Open the cleaning kit, using wrapper as a sterile field.
Open dressings and other supplies and place on sterile field.
(3) Pour hydrogen peroxide in one basin and sterile saline in the other
(disposable basins/containers are included in the kit).
f. Put on exam gloves and remove soiled tracheostomy dressing.
Tracheostomy secretions should be considered contaminated and handled accordingly.
g. Remove and discard exam gloves and put on sterile gloves.
h. Clean inner cannula, if present.
Unlock the inner cannula and remove.