How to Prevent Illness and Infection
I refer to ‘you’ throughout this video for the sake of not listing all of the people
involved in helping you with your trach. ‘You’ includes you, your family, friends and any
other caregiver In this video you will learn how to prevent
illness and infection. This video will tell you what you need to do before you clean your
trach, how to prepare your cleaning solutions and how to clean your trach tube.
It is important to learn how to clean and suction your trach tube. A clean trach tube
will let you breathe better and may help to prevent infections to your lungs or to your
skin around the trach tube. This section will review what you must do every day to clean
your trach tube. Before you clean your trach tube, wash your
hands. This can help to prevent infections when you start cleaning your trach.
Gather following supplies and place them on a clean and flat table top
or counter. • 3 % Hydrogen peroxide
• Normal saline (salt water) • Trach brush
• Q tips or cotton tipped swabs
• Vaseline or petroleum jelly • Trach gauze
• Clean, Velcro ties • Four (4) small, clean cups (they
can be disposable) • 3cc syringe
• Tissues • Small, free standing mirror
• Suction machine with suction tubing • Suction catheters
Prepare your cleaning solutions in the 4 small, clean cups.
In the first cup fill half the cup with 3% hydrogen peroxide.
Follow these directions to make the normal saline solution for the next three cups. Collect the following ingredients:
• Half a teaspoon (2ml) of salt • 1 cup (250 ml) of boiled water Mix the salt in the cup of boiled water until
the salt is dissolved. Let the saline cool to room temperature. Then
keep it in the fridge until 30 minutes before use. This will allow for the saline to return
to room temperature. After 2-3 days, make a new batch as old normal
saline can grow bacteria. Take the normal saline out of the fridge 30
minutes before use. In the other 3 cups, fill half of each cup
with normal saline. You will now have 4 cups, each half filled with solutions you need to
clean your trach tube. When you first get your trach tube it will
need to be cleaned 3-4 times a day. Most people, when leaving the hospital, only need to clean
the trach tube after waking-up in the morning, before going to sleep at night and at other
times as needed. To clean your trach, do the following:
1. Saline squirts 2. Suction your trach tube
3. Clean your inner cannula 4.Clean your skin around your trach
Saline squirts break up airway secretions and clear your trach tube. Sit in front of
a mirror. Fill a 3cc syringe with saline from one of the cups. Have a tissue nearby as you
will cough secretions out of your trach tube. While taking a deep breath, squirt the saline
into your trach tube. It is important to remember that saline squirts
are not advised for all patients. If you have not had head and neck surgery or if you have
not had head and neck cancer, ask your doctor if saline squirts should be part of your trach
care. Suctioning clears airway secretions in your
trach tube that were not coughed out with the saline squirt. Suction when you wake up
every morning, before you go to bed at night and during the day when needed.
You need to do saline squirts and suction if it is hard for you to breathe. Or if you
hear rattling, gurgling or wheezing from within your trach tube.
Suction your trach tube by following these 5 steps:
Step one. Plug in the suction machine. Make sure you have the right tubing and catheters.
Turn the suction machine on. Adjust the suction setting as recommended by your nurse or health
care team Step two. Rinse the suction catheter.
To rinse the catheter, place the tip in the saline solution. Cover the hole of the catheter
with your thumb. This causes suctioning of the normal saline through the catheter.
Step three. Put the suction catheter about 10 - 12 cm (3 - 4 inches) in your
trach tube. When doing this, do not apply suction. Applying suction will make it harder
to insert the catheter and may make you feel short of breath.
Step four. Begin suctioning by putting your thumb on the hole of the suction catheter.
Step five. Slowly remove the catheter from your trach tube by twisting it side to side with your fingers while applying suction.
Here are some helpful tips to remember when suctioning your trach tube at home:
Use a new suction catheter each time you clean your trach tube.
Do not leave the suction catheter in your trach tube for longer than 10 seconds at
a time. This may cause you to feel short of breath.
Rinse your suction catheter in normal saline to clear thick secretions before you continue
cleaning your trach tube. When you finish cleaning your trach tube, throw away
the saline, the disposable cup and the used catheter.
Clean your inner cannula so secretions do not build up in your trach tube. This will
help you breathe better. Hold your trach plate in place with the fingers
on your non dominant hand (for example, if you are right handed, hold the trach plate
with your left hand). Unlock your inner cannula with your dominant hand by slowly turning
it to the right. You will know the inner cannula is unlocked because you will hear or feel
a click. Hold your trach plate in place while slowly
taking out the inner cannula. Place the inner cannula in the cup of 3% hydrogen
peroxide solution. Let it soak for at least one minute. Throw away the 3% hydrogen peroxide
and disposable cup after soaking. Clean the inside of your inner cannula with
your trach brush. Once all secretions have been removed, rinse your inner cannula under
running tap water. Gently shake the inner cannula to remove water on or in the cannula.
It is okay if your cannula is not completely dry.
Put the inner cannula back into your trach tube. Hold your trach plate in place with
your fingers from your non dominant hand. Put your inner cannula back into your outer
cannula. Once this is in place, slowly turn the inner cannula to the left until it locks
and you hear or feel a click. Clean the skin around your trach plate to
prevent skin irritation and infections. The skin around your trach plate can be cleaned
with normal saline solution. If you have lots of build-up (crusting) on your skin, use 3%
hydrogen peroxide before using normal saline to clean your skin.
To clean your skin, dip a Q-tip (or cotton tipped swab) in a cup of normal saline (or
3% hydrogen peroxide). Use the Q-tip to gently clean the skin around
your trach plate. Try not to move your trach tube while doing so. Repeat until your skin
and the trach plate are clean. Use a new Q-tip to apply a thin layer of Vaseline
or petroleum jelly on the skin around your trach plate. This will protect your skin from
becoming irritated and sore from airway secretions you cough out. If you need oxygen to help
you breathe, do not use Vaseline. Talk to your health care provider.
Put trach gauze under your trach plate. This also protects the skin from irritation.
If there is redness, pain or discharge on the area of skin around your trach tube, ask
your nurse or doctor to look at it. If you are having radiation therapy, your skin around
the trach tube will change during treatment. Your radiation doctor will see you every week
and will discuss the care required for your skin.
You have come to the end of the video on cleaning your trach at home. In this video you learned how to prevent illness
and infection when caring for your trach by learning how to do saline squirts, how to
suction your trach tube, clean the inner cannula and to clean the skin around your trach plate. Cleaning your trach is not easy. Watch this
video as many times as you would like. It is important that you feel comfortable caring
for your trach on your own.