Tracheostomy

Key Steps — Tracheostomy care

This video shows tracheostomy care in a real care setting, without narration. The checklist below is the standard nursing care sequence for a patient with a tracheostomy.

1. Keep emergency equipment at the bedside at all times: suction, a spare tracheostomy tube of the same size and one smaller, and an obturator.
2. Perform hand hygiene, explain each step to the patient, and position them semi-upright unless contraindicated.
3. Assess breathing, oxygen saturation and the stoma, and suction the airway first if secretions are present.
4. If the tube has a removable inner cannula, unlock and remove it, clean or replace it as policy directs, and reinsert it until it clicks or locks into place.
5. Clean the stoma with the solution used locally, working outward, and inspect the skin for redness, breakdown or discharge.
6. Change soiled tracheostomy ties or tapes with a second person holding the tube — or keep one finger's worth of slack — so the tube cannot dislodge.
7. Check that humidification is in place, as the upper airway's warming and filtering is bypassed.
8. Confirm the tube is secure, the patient is breathing comfortably, and suction is working before you leave.
9. Document the care given, the stoma's condition and how the patient tolerated it.

Steps summarise this demonstration for education. Always follow your institution's protocol. More Respiratory Care skills →