Trach Care – Daily Cleaning Routine

by Feb 25, 2019ALS0 comments

 Trach Care
Daily Cleaning Routine

Disclaimer: This is in no way medical advice. We are not doctors and have no professional medical training. Based on what we have learned and what works for us, we share what we know with the hope of helping increase awareness of the reality of life with a trach, ventilator and ALS.

*Before reading about the daily routine you might want to start with our overiew of trach care if you haven’t checked it out already.*

Each morning starts with the cleaning part of trach care routine. Keeping the trach site clean is important to keep infections away. Typically this routine takes about 15-20 minutes.


Supplies for the morning routine include:
Trach care kit
Hydrogen peroxide
Distilled water
Surgical gloves
New inner cannula
New trach collar

The Routine

The routine involves:
Gathering and preparing the supplies
Cleaning the trach site
Replacing the gauze and collar
Replace inner cannula

If you prefer to skip the reading you can watch the video at the bottom or on YouTube here.

Gather and Prepare Supplies

Once I’ve gathered the supplies I then  open the trach care kit, remove the contents onto a clean surface, pour some hydrogen peroxide in one side of the tray and distilled water in the other.

The old gauze (split sponge) around the stoma gets removed.  After that I wash my hands thoroughly and put on gloves.

Clean the Trach Site

Cotton swabs are dipped into the peroxide and used to rub all around the stoma site of the trach. I use both swabs each day, circling around the site several times to ensure the entire area gets peroxide.

Next, some of the gauze from the trach care kits gets soaked in the distilled water. I wring that out on top of the trach so that it runs down around the stoma, catching it with a paper towel underneath. This is done to rinse away any peroxide. I then use another gauze from the kit to dab around the site to ensure it’s dry.

Replace Collar and Gauze

After that, I replace the trach collar if it needs it. Typically the collar stays pretty clean and dry, so I only change it out every few days. When I do change it, I do it after I’ve used the peroxide and water.

Next, new gauze (split sponge) is placed under the stoma and collar. This should be tight around the stoma, ensuring to catch any leakage. I also examine the split sponge when I remove it each morning. I check the color of the discharge. There is typically at least a little. I look for blood and/or pus. The presence of either of those should be monitored closely. The last thing you want is an infection!

Replace Inner Cannula

Now it’s time to switch out the inner cannula. At this point I put on fresh gloves, as the new cannula will be going into Brian’s body so I want to be sure my hands are as clean as they can be. Replacing the cannula means taking off the vent circuit, removing the old cannula, and inserting the new one, then reconnecting the circuit. Even after a year and a half Brian will typically gag a little when the cannula gets switched out.

There You Have It!

Like most ventilator tasks, it might seem overwhelming at first but rest assured…you got this! It quickly becomes like any other ‘normal’ routine. My suggestion would be to get this done and over with first thing in the morning. There have been a couple of times where I didn’t do it in the morning, then either forgot or didn’t feel like it later, but again, it’s a step that really shouldn’t be skipped if at all possible.





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