Essential Tracheostomy Care: Best Practices for Effective Management

A tracheostomy is a critical surgical procedure, either planned or performed as an emergency, designed to assist individuals experiencing difficulty breathing. This life-saving intervention involves creating an opening in the neck to facilitate airflow and is typically carried out in a hospital operating room. Essential for managing upper airway obstructions or chronic respiratory conditions, the procedure provides immediate relief and sustains vital functions. Once discharged, individuals with a tracheostomy require proper techniques, meticulous care, and a well-structured plan to manage the tracheostomy at home, ensuring both safety and an improved quality of life.

Why Would Someone Need a Tracheostomy Procedure?

A surgical procedure for tracheostomy tubes may be required for:



Airway Obstruction: Caused by tumours, injuries, or swelling.

Chronic Respiratory Failure: Requiring long-term ventilation.

Neurological Disorders: Conditions like ALS or stroke impairing respiratory functions.

Medical Emergency: To provide immediate access to the airway during life-threatening situations.

Depending on the condition, a tracheostomy may be temporary, or you may require a permanent tracheostomy tube.

What Happens When You Have a Tracheostomy?

When a tracheostomy surgical procedure is performed, a surgical opening often referred to as a tracheostomy hole is created in the neck to insert a tracheostomy tube. This opening allows breathing to occur directly through the tracheostomy tube, bypassing the nose, mouth, and upper airway. Because the procedure is below the voice box (vocal cords), it can impact speech. However, with the use of tools such as speaking valves or specialised tracheostomy tubes, many patients regain their ability to speak, often with the help of a speech therapist to enhance communication.

Ventilator Support with a Tracheostomy Tube

In cases where breathing independently is difficult or impossible, a tracheostomy tube can be connected to a breathing machine. The ventilator delivers a controlled flow of oxygen directly to the lungs, ensuring adequate oxygen levels. This respiratory system setup is commonly used for individuals with chronic respiratory failure, neurological conditions, or post-surgical recovery. Proper maintenance of both the tracheotomy tube and mechanical ventilation equipment is essential for safety and effectiveness.

Essential Components for Tracheostomy Management

Proper management of a tracheostomy requires familiarity with its key components. Each part plays a critical role in ensuring the tube functions effectively and comfortably.

1. Heat and Moisture Exchanger (HME)

An HME is a small, essential device placed at the end of a tracheostomy tube. It helps mimic the natural humidification process of the upper airway, which is bypassed due to the tracheostomy. By trapping heat and moisture from exhaled air and returning it to inhaled air, the HME prevents dryness in the airways and reduces the risk of mucus buildup. It is particularly beneficial for patients not connected to a ventilator.

2. Inner Cannula (or Inner Tube)

The inner cannula, also referred to as the inner tube, is a removable portion of the tracheostomy tube. It ensures the airway remains clear by allowing easy cleaning to remove mucus or debris. Regular cleaning of the inner cannula is vital to prevent blockages and maintain proper airflow.

3. Tracheostomy Tie

The tracheostomy tie is a strap that secures the tracheostomy tube in place around the neck. Properly fitted ties prevent the tube from becoming dislodged while ensuring the patient’s comfort. Regular adjustments and inspections are necessary to avoid skin irritation or tightness, which could lead to discomfort or complications.

Why These Components Are Important

Understanding the role of each component is crucial for effective tracheostomy management. Proper use of devices like HMEs, maintenance of the inner cannula, and secure yet comfortable placement of tracheostomy ties help ensure the safety and comfort of individuals with tracheostomies. These elements are part of the routine care, such as Flame Lily’s nursing services, who can guide and assist caregivers in managing these essential components.

Understanding Tracheostomy Care

Tracheostomy management involves:

Cleaning and Maintenance: Regularly cleaning the tube and stoma to prevent infections.

Airway Management:  Suctioning to remove mucus and maintain clear airways.

Monitoring for Complications:  Watching for signs of infection, blockages, or other issues.

Healthcare providers play a crucial role in tracheostomy support, providing guidance, training, and regular check-ups to ensure the patient's safety and well-being.

How Do You Take Care of a Tracheostomy?

Proper tracheostomy procedures includes:

Cleaning the Stoma and Tube

Gently clean the tracheostomy site with sterile saline to remove mucus and debris.

Replace dressings as needed to keep the area dry.

Suctioning the Airway

Suctioning is a vital step to maintain a clear airway and prevent blockages caused by mucus buildup.

Steps for Effective Suctioning:

• Prepare the Equipment: Turn on the suction machine. If you are in the hospital, open the clamp on the suction tubing instead.
• Perform Suctioning: Pinch the suction catheter between your thumb and pointer finger to block the suction, and cough deeply to bring up secretions. Insert the catheter into the tracheostomy tube to clear mucus.
• Aftercare: Rinse the suction catheter with sterile water after use and store all equipment in a clean, dry area.

Avoid over-suctioning, which can irritate the airway, and always use sterile equipment to minimise infection risks.

Humidifying the Airway

Since the tracheostomy bypasses the natural humidification process of the nose, devices like heat moisture exchangers (HMEs) or humidifiers are essential.

Inspecting Equipment

Regularly check the tracheostomy tube and replace it when necessary.

Tips for Safe and Effective Tracheostomy Management

Maintain Cleanliness and Hygiene:

Always wash hands before handling the tracheostomy tube or stoma.

Understand Limitations:

Avoid swimming or submersion in water and keep the stoma protected from irritants like dust and smoke.

Emergency Preparedness:

Keep spare tubing and equipment readily available for emergencies.

Possible Complications and Prevention

The most common complications include:

• Infections: Prevent by maintaining hygiene and monitoring for redness, swelling, or discharge.
• Airway Obstructions: These are caused by mucus buildup and are addressed through regular suctioning and humidification.
• Accidental Decannulation: Ensure caregivers are trained to replace the tube if necessary.

NDIS Funding for Tracheostomy

The National Disability Insurance Scheme (NDIS) funds tracheostomy support for participants with respiratory needs, enabling them to live safely and independently at home.

Why Would the NDIS Fund Tracheostomy?

NDIS funds tracheostomy if it:

• Relates directly to the participant’s disability or health condition.
• Ensures the participant’s safety and quality of life.
• Other healthcare systems, such as Medicare, cannot provide it.

When Does the NDIS Fund Tracheostomy Support?

Funding is included in an NDIS plan if a healthcare provider submits evidence of the participant’s need for tracheostomy support, a detailed tracheostomy plan, and the participant meets the eligibility criteria set by the NDIS.

Relevant NDIS Funding Categories

1. Core Supports: Covers daily living assistance, such as cleaning and maintaining the tracheostomy tube.
2. Capacity Building Supports: Provides training for caregivers to manage tracheostomy handling.
3. High-Intensity Daily Personal Activities: Supports advanced tasks like suctioning and airway management, performed by trained professionals.

How Flame Lily Supports Tracheostomy Management

Flame Lily offers professional NDIS nursing services to ensure safe and effective tracheostomy support for participants.

Our Services Include:

• Cleaning and Maintenance: Routine care for the tracheostomy tube and stoma.
• Airway Management: Suctioning and monitoring for complications.
• Emergency Preparedness: Training for caregivers to handle emergencies confidently.
• Personalised Care Plans: Tailored to meet individual needs under NDIS high-intensity support.

Living Confidently with a Tracheostomy

While living with a tracheostomy requires adjustments, proper care and support enable individuals to lead fulfilling lives. Whether temporary or permanent, the right tools, training, and professional assistance empower patients and caregivers to manage this condition with confidence and peace of mind.

For expert assistance, contact Flame Lily today to explore our  NDIS high-intensity support services and discover how we can help with tracheostomy at home or remotely. We are here to be a part of your healthcare team and support you on your tracheostomy journey.