A tracheostomy, commonly referred to as a trach, refers to a hole created within the windpipe (trachea). This procedure is performed by an experienced surgeon. 

The hole, typically called a stoma, serves as a replacement for the person's nose and mouth. It is the primary pathway they rely on for breathing. Once the stoma is created a trach tube is inserted into the opening to keep this hole open and provide entry into the lungs. 

Tracheostomy equipment can be tricky to manage for caregivers. Here are a few tips you can rely on; 

Different Kinds of Tracheostomy Tubes

Let's learn a bit more about the varying kinds of tracheostomy tubes out there and how they are typically used starting with an outer cannula. 

The outer cannula forms the primary body of the tube. It is often secured to the neck through a Velcro strap. This along with the cuff (a balloon attached to the outside of the tube) ensures that patients attached to mechanical ventilators are getting the aspiration they require.   

You may also require trach tubes with no cuffs. These are usually found in patients who aren't on a ventilator, can breathe on their own, and can swallow easily. 

Inner cannulas on the other hand will fit comfortably inside the trach tube, lining it up nicely. This lining can be removed and cleaned to avoid mucus build up. A great example is the Shiley inner cannula which performs this function quite well. 

Last but not the least is the obturator which is commonly needed for placement of a trach tube or in case of trach changes. It's needed to protect the airway from getting damaged as the tube is inserted. Since it has rounded tips, it performs this function exceptionally. 

How You Can Manage Tracheostomy Equipment 

  1. Make sure everything is clean and ready and don't forget to wash those hands or use gloves each time you deal with the equipment. Store supplies like suction catheters, spare trach tubes, and cleaning swabs in clean, dry containers.
  2. Clean often and set schedules for equipment that needs to be sterilized. Follow manufacturer's instructions for cannulas, humidifiers, and suction machines. Don't forget to check for any cracks, blockages, or worn-out parts.
  3. Always be prepared with an emergency kit containing spare trach tubes, obturator, suction catheters, saline vials, and scissors.  
  4. Master suctioning techniques that allow you to easily keep the airway clear. Avoid making too many errors or overdoing it!
  5. Note when you last changed equipment, cleaned the parts, or replaced supplies to stay on track.

Assisting a Patient with a Tracheostomy

There are a few important details to keep in mind; 

1. Keeping the Air Moist and Warm

Breathing through a tracheostomy all the time can be uncomfortable to say the least. The air skips the nose and mouth. Since this air normally keeps these airways warm and moist, the absence of it can have detrimental effects. The nose and mouth can get dry pretty fast. 

Instead of letting the patient deal with the tiny but irritating roadblocks, you can consider investing in a heated humidifier. It zaps the rooms with warmth and moisture immediately and makes breathing smoother and much more comfortable. 

2. Honoring Their Wishes

If the patient submits a request, make sure they are heard. It can be quite frustrating when one is unable to speak for months at a time. Let's focus on making this experience as stress-free for them as possible. 

Suppose your loved one wishes to speak. Since trach tubes sit right below the vocal cords, it cuts off the air supply to the cords. This is easy to fix through a cuff deflation or speaking valve which allows this air to pass over the vocal cords again. 

However, you cannot make this adjustment on your own. It is important to rely on a professional who can help the patient transition. Failing to deflate the cuff before using a valve or cap can be deadly for the patient. Moreover, only a professional can determine whether the patient is physically ready for the transition or not. 

3. Clean, Clean, Clean

The stoma needs cleaning at least twice a day, with a 50/50 mix of sterile water and hydrogen peroxide. It doesn't take that much time and is a strong shield against germs and infection. Remember to slip a fresh gauze under the tube when you are done. 

Set a schedule and do not skip it. Plastic trach tubes need to be replaced every two weeks whereas metal tubes might last longer. 

You're Not Alone

Consider the respiratory therapists, nurses, and doctors your best friends. They can help you learn a lot more about your loved one's needs. 

The more questions you ask the easier it would be for you to understand aftercare at all stages of the tracheostomy. Don't hesitate to contact them as soon as you feel like something is off. With proper guidance, tracheostomies don't need to feel as scary.