(2) Place the inner cannula in the hydrogen peroxide, allowing it to soak for
a few minutes.
Clean the inner cannula with the test tube brush.
Rinse the inner cannula in the sterile saline.
(5) Remove the inner cannula from the saline and allow it to drain on a
sterile 4x4 gauze sponge.
Cleanse the tracheostomy incision and surrounding area with antiseptic
If crusting occurs, remove with sterile swabs soaked in hydrogen
Do not allow cleansing solutions to enter the tracheostomy opening.
Reinsert the inner cannula and lock in place.
k. Apply sterile tracheostomy dressing. Use precut, non-raveling sterile 4x4.
Place it with the slit toward the chin, allowing the uncut portion to absorb secretions.
(1) Cut and remove soiled, outer tube ties if necessary. The patient or an
assistant should hold the outer tube in place to prevent dislodgement of the tube.
NOTE: If an assistant is not available and the ties must be changed, secure new ties in
place before cutting and removing soiled ties.
Cut a slit about one inch from the end of each tape.
(3) Insert the slit end of the tape through the flange of the outer cannula,
and draw the other end of the tape through the slit (Figure 2-6).