Health Information and Tools > Patient Care Handouts >  Your Tracheostomy: Care Instructions
Facebook Tweet Email Share

Main Content

Your Tracheostomy: Care Instructions

Your Care Instructions

A tracheostomy is a surgical opening through the neck into the windpipe (trachea). The opening is also called a stoma. A tracheostomy helps you breathe if you have a lung or nerve problem, an infection, or trouble handling secretions.

A tracheostomy is a permanent opening through the neck into the windpipe, or trachea. This opening makes breathing easier if you have a lung or nerve problem or an infection that makes it hard to breathe.

Taking good care of a tracheostomy is very important. It can prevent infections and help keep you breathing easily.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

General tips

Your doctor or nurse will give you instructions about how to take care of your tracheostomy (trach). This will include how to suction your trach, how to clean the opening in your neck (stoma), and how to clean and replace the trach'sinner tube (inner cannula). Be sure to follow all of these instructions closely.

  • Have your emergency supplies ready and available wherever you are.
  • Always wash your hands before and after caring for your tracheostomy.
  • Keep the air in your home moist with a room humidifier.
  • Eat while sitting up. If any food gets into the tube, suction it out right away.
  • Wear clothing that is loose around your neck, and avoid clothing with loose fibres.
  • In a bath or shower, avoid getting water into the tracheostomy. Cover the tube so that no water gets in but you can still breathe. You can also shower with your back to the water.
  • Do not swim.
  • Replace the tube holder if it gets wet or damaged. If it is not damaged, it can be washed and dried and used again.
  • Your tracheostomy, or "trach" (say "trayk"), has three parts: the outer cannula, the inner cannula, and the obturator. The inner cannula is the piece that you will remove and clean.
  • Your doctor may give you more instructions. Follow them closely.


Always have suction supplies ready, including a fully charged suction machine. Suction the trach 3 to 4 times a day, or more if needed. For example, two of the times could be before you go to bed and when you wake up in the morning. You will need suction catheters, a suction machine, saline fluid, a small cup, and a mirror. Here are the steps to take:

  1. Wash your hands with soap and water for at least 30 seconds.
  2. Pour saline fluid into the cup.
  3. Connect a catheter to the suction machine tubing. Dip the catheter tip into the saline fluid. Insert the wet catheter into the trach. Push the tube in gently, about 7 to 10 centimetres, until you feel it hit something.
  4. Slowly pull the catheter out of the trach, rolling it back and forth between your fingers, with your thumb over the control valve (this turns the suction on). Do not keep the suction on for more than 10 seconds at a time.
  5. Wait about 30 seconds and repeat inserting and pulling out the tube until all the mucus has been removed. Then suction the saline left in the cup.
  6. Throw away the used catheter, and wash your hands again.

Stoma care

The opening in your neck is called a stoma. To care for your stoma, clean and dry it 3 times a day. Do not let crust form on the skin at the stoma. You will need hydrogen peroxide, tap or sterile water, 8 or 10 cotton swabs, 2 small cups, a dry cloth, a mirror, and ointment for the skin. Follow these steps:

  1. Wash your hands with soap and water for at least 30 seconds.
  2. Fill one cup with half water and half hydrogen peroxide. Put 3 or 4 cotton swabs in the cup. Fill the other cup with water and put 3 or 4 swabs in that cup.
  3. Clean and remove dried mucus around the stoma with the cotton swabs in the peroxide cup. Then clean off any peroxide with the swabs in the water cup.
  4. Dry your skin with the cloth. Apply ointment with the remaining swabs.
  5. Wash your hands again.

Cleaning the inner cannula

A cannula is the tube that fits into the stoma. Clean and replace the inner cannula 2 or 3 times each day. You will need 2 small bowls, a small brush, hydrogen peroxide, water, and a mirror. To clean the inner cannula:

  1. Wash your hands with soap and water for at least 30 seconds.
  2. Pour half water and half hydrogen peroxide into one bowl. Pour a small amount of water in the other bowl.
  3. Unlock the inner cannula and remove it by gently pulling it out and down. Put this into the peroxide bowl to soak. Clean the inside and outside of the cannula with the brush.
  4. Rinse the cannula under tap water, then let it soak in the bowl of water. Shake the cannula out and slide it gently back into the outer cannula. Turn it to lock it in place. Make sure it is locked in place and you cannot pull it out.
  5. Wash your hands again.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing, and coughing or suctioning does not help.
  • Your trach falls out and you cannot get it back in.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have trouble breathing after suctioning.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness in the stoma.
    • Red streaks leading from the stoma.
    • Pus draining from the stoma.
    • A fever.
  • Your secretions change.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.