Having a Tracheostomy
Changing Outter Tubes
Changing of the outer tube can be carried out by the hospital staff and the specialist nurse at first. When you are at home the outer tube will be changed by the specialist nurse (this can be done at home or in hospital) or a district nurse (at home). You and your family will be shown how to do this as soon as you are ready.
Once you are familiar with your stoma, it is well established and you are confident at changing your outer tube, you will require the following:
- a clean area to lay out equipment
- a clean tracheostomy tube set
- velcro tube holder/ tapes
- lubricating gel
- a tracheostomy dressing (if worn)
- gauze/wipes or a clean flannel to clean round the stoma
- Saline or cooled boiled water
- Scissors
- a mirror
- suction equipment
- tissues
Procedure
- Ensure the new tube is clean and ready for use.
- Ensure a clean surface and lay out container of cleaning fluid and some wipes / gauze.
- Prepare the tracheostomy for inserting. Apply the Velcro holders / tapes to the sides of the outer tube to secure around the neck.
- Insert the introducer
- Apply lubricating gel to the outer tube. The tube is now ready to insert.
- Make sure everything is close at hand and you have a good light.
- Make sure you clear any secretions before you start.
- Standing or sitting in front of your mirror, undo the velcro holder (or cut the tapes) on the tube you are wearing and remove the old tube using a downward movement and breathing out slowly.
- Wipe around the stoma area with a moist gauze or wipe to remove any secretions and then dry.
- Insert the clean tube immediately and remove the introducer whilst breathing out slowly.
- Hold the tube in position with one hand and check the position by holding the other in front of the tube to feel the air passing in and out.
- Tie the tube in place.
- Put a clean dressing in place (if worn) and check that your tracheostomy tube feels comfortable.
- Remove tapes from the dirty tube and discard.
- Silver tracheostomy tubes or silicone tracheostomy tubes can be cleaned and reused. Plastic tubes will be discarded and a new set used on a monthly basis. Your specialist nurse will advise you on this.