Having a Tracheostomy

Most tracheostomy tubes now have inner tubes. This means that the outer tube can stay in for longer. The outer tube should be changed on a monthly basis, but this may depend on the type of tracheostomy tube you have in place. Your specialist nurse will discuss this with you. There are different types of tracheostomy tubes made of, plastic (PVC), silicone or silver and they are usually packed together as a set. The tracheostomy set consists of:

• outer tube
• inner tubes ( usually 2or 3)
• introducer (used to insert the outer tube)

The inner tube should be removed and cleaned at least twice a day (morning and night), or more often if necessary if you have a lot of secretions. Once the dirty inner tube is removed, a clean tube (from the same tracheostomy set) should be inserted straight away. This will ensure that secretions do not enter the outer tube.

Plastic Tubes - (Shiley, Portex, Tracoe)

1. Ensure a clean inner tube is ready to use.
2. Remove the dirty inner tube and place on a tissue or into a plastic container. Insert the clean inner tube and secure in place.
3. Clean the dirty inner tube with warm soapy water using a tracheostomy cleaning brush or tracheostomy cleaning swabs. Do this until all the mucus is removed and then rinse through with clean water.
4. Soak the inner tube in a container of sterilizing solution for 15 minutes (eg a baby bottle sterilizing solution such as Milton) ensuring the whole tube is immersed.
5. After 15minutes remove the inner tube from the sterilizing solution and shake dry.
6. Store the inner tube in a covered container ready to use.

The outer tubes are usually disposed of when they are changed and a complete new set used each time.

Silver Tubes (Negus) and Silicone Tubes

1. Ensure a clean inner tube is ready to use.
2. Remove the dirty inner tube and place on a tissue or into a plastic container. Insert the clean inner tube and secure in place.
3. Clean the dirty inner tube with warm soapy water using a tracheostomy cleaning brush or tracheostomy cleaning swabs, until all the mucus is removed. Rinse through with clean water.
4. Place the inner tube in a heat resistant container and cover with boiling water and leave for 5 minutes.
5. Carefully remove the inner tube from the water, allow to dry, and store in a clean container with a cover ready to use.

The outer tubes are reused and are cleaned in the same way as the inner tube and stored dry ready to use.