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 or soft collar clean

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

You may have been told to use a hook and loop fastener or a soft collar. If so, follow the instructions that your care team gave you.

Trach ties fit right if you can put one finger 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 suction machine. It will be ordered for you before you leave the hospital. You will be told how to suction and how often.

• Moisten the air you breathe. Usually, the nose moistens the air as it is breathed in. With a tracheostomy, you need another way to moisten the air. For example, you could use a humidifier. Ask your health care provider how to moisten the air.

• Do not wear clothing that blocks the opening of the trach tube. This includes turtleneck shirts and tightly wrapped scarves. You can use a loose-fitting scarf to hide the trach tube. You can also use it to protect the tube from cold air and dust. Make sure the scarf does not shed lint, have loose fibers, or block air flow. Medical supply stores may sell trach coverings. They may also sell shields for use in the shower.

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

When to contact your doctor

Contact your health care provider right away if you have:

• A red or painful stoma.

• A small amount of bleeding from the stoma or tube that stops promptly.

• A fever of 100.4°F ( 38°C) or higher, or as advised by your provider.

• Yellow, bad-smelling, bloody, or thick mucus.

• Vomiting that does not go away.

Call 911

Call 911 right away if any of these occur:

• Large amount of bleeding or lasting bleeding from the tracheostomy site

• Coughing up blood

• Swelling around the trach tube

• New or worsening trouble breathing