Having a Tracheostomy

Before you leave hospital you will be taught by the nurses how to take care of your tracheostomy (stoma). You will go home when you are confident and feel ready. Most people are surprised how easily they learn to look after their tracheostomy. Also the care needed is safe, simple and does not take too much time.

Before you go home a portable suction unit and a nebuliser (an air compressor) will be ordered for you to take home. It is essential that this is available before you go home. You and your family will be taught how to use this equipment before you go home.

When you go home you will be able to have some help arranged for you. This may include visits from the District Nurses, Home helps, social services and your GP for example. You will probably meet your specialist nurse before leaving the ward and will be given his/her contact number. The specialist nurses help sort out any problems you have once you are home.

They may help the district nurses care for your tracheostomy and get medical equipment for you, or help sort out benefits you may be entitled to for example. They are there to provide you with whatever help and support you may need in relation to your tracheostomy or life because of it.

This is not normally required. However if you have specific needs then home oxygen can be organized for you.

The tracheostomy tube must stay in the stoma at all times and the main plate of the tracheostomy tube, called the flange, should sit closely to the neck to keep its position. When you put your hand over the tracheostomy you should feel a good flow of warm air as you breathe.

The soft velcro collars around the neck (tracheostomy tube holders) should fit snugly around the neck and should not be too loose as this will allow the tube rub the stoma and the windpipe. You and your family will be shown how to do this safely.

Cleaning around the stoma

You will need to clean the area around your tracheostomy tube at least twice a day, more often if necessary. The tube does not need to be removed for this.

• Clean around the stoma and tube with moist gauze pieces or clean wipes.
• Gently wipe away any secretions that may have built up around the stoma and beneath the plate of the tracheostomy tube.
• Sometimes mucus dries around the stoma and the tube, forming crusts. These need to be moistened with moist gauze and gently removed with forceps/tweezers if necessary. If the crusts are quite hard and difficult to remove, they may be softened with a small amount of lubrication gel or Vaseline.
• You may wish to wear a small dressing beneath the tracheostomy tube for comfort or to absorb any secretions. This will need to be changed at least once a day or more often if you have lots of secretions. The nurses will discuss this with you and show you how to do this.
• Occasionally the skin around the stoma becomes sore, should this happen Vaseline, E45, Urgentum Merck cream or Cavillon can be used to protect the skin. If the soreness persists please see your GP, district nurses or specialist nurse for advice.
• If you are undergoing radiotherapy you will be given specific information and advice from the consultant and specialist nurses on how to care for skin.

Do not allow anything to enter the trachea when you are cleaning the stoma, as it may irritate and make you cough.

When you have had your tracheostomy for a while, cleaning can be undertaken using a clean flannel and water instead of pieces of wet gauze.