Tracheostomy tubes
Tracheostomy tubes
There are different types and sizes of tracheostomy tubes. The size of the child’s tube changes as they grow [5]. Usually tracheostomy tubes are changed once a week. This is to keep the tube clear of old secretions.
It is best to change the child’s tube either before a feed or at least an hour after a feed.
This reduces the risk of the child vomiting [2]. You will need an assistant when you change the tube [2, 6].
Changing a tracheostomy tube equipment required
- a rolled up towel to place behind the child’s shoulders
- cotton tipped swabs to clean around the tracheostomy tube
- sodium chloride to clean around the tracheostomy
- a clean tracheostomy tube of the same size with an introducer (obturator)
- a clean tracheostomy tube a size smaller with an introducer (obturator)
- introducer (obturator) for the tracheostomy tube that is currently in place
- tracheostomy tapes or ties
- gloves goggles and rubbish bag
- water based lubricant (optional)
- humidification filter
- oxygen
- suction machine
- suction catheter
- an assistant
It is also important to check the equipment prior to changing the tracheostomy tube.
» Video of required tracheostomy tube equipment [wmv]
» Video of tracheostomy tube equipment checking [wmv]
Procedure for changing a tracheostomy tube
Changing a tracheostomy tube [1]
- Wash and dry your hands [2].
- Make sure the clean tube has no cracks and is flexible [2].
- Check that the introducer is easy to place in and out of the tube [2, 6].
- Attach clean ties or straps to the clean tube. Place the introducer in the tube. Lubricate the tip of the tube if needed [2].
- Position the child so you have good access to their tube [2, 6].
- Suction the child’s current tube before you change it [2].
- Your helper should hold the current tube while you remove the old ties or straps.
- When you are ready, ask your helper to remove the tube [2, 6].
- Place the clean tube in your child’s tracheostomy. Use a curved motion to follow the shape of the windpipe. The child may cough as the tube is changed [2, 6].
- Hold the clean tube in place and remove the introducer [2, 6].
- Ask your helper to hold the tube while you secure the ties or straps [2, 6].
If you have any problems changing your child’s tube try the following; tilt your child’s head back a little further with your fingers beside the stoma, widen the opening and replace the tube.
If you are still unable to place your child’s usual size tube, try to insert the emergency tube which is a size smaller. If the smaller size tube is used please contact the ENT Doctor or clinical nurse consultant for technology dependent children within 24 hours.
» Video of changing a tracheostomy tube on a mannequin [wmv]