DO YOU KNOW...

How to clean a trach site

 

How often should I clean around my child’s tracheostomy (trach)?

  • You should clean around your child’s tracheostomy (trach) at least 2 times each day, and
  • When the site has a lot of wet mucus around it or dried, crusty mucus.

Getting ready

  • Wash your hands with soap and water. Dry them well. See “Do you know… Clean hands.”
  • Gather your supplies onto a clean work area and open them so they are within easy reach.
  • These are the supplies you need. The numbers in the picture match the items on the list.
Supplies to clean trach site
  1. Cotton tip swabs
  2. Sterile water or sterile saline wipes (wipes not shown)
  3. Hydrogen peroxide (only if needed)
  4. 2x2 split IV gauze pads
  5. 2x2 regular gauze pads
  6. Medicine cups or several small, clean containers
  7. Non-sterile gloves – Size_________
  8. Rolled towel or small blanket

 

 

  • Prepare your supplies as directed below.
    • If your child has crusty mucus around his trach site, make a mixture of 10 ml hydrogen peroxide to 10 ml sterile water or saline in a medicine cup or small, clean container. (Only use the mixture if sterile saline wipes will not remove the mucus.)
    • If the trach site has drainage only, open a sterile water and pour into a medicine cup or a small, clean container. Or use a sterile saline wipe to clean around the site.
    • Place  arolled towel or small blanket under your child’s shoulders to make the stoma area easier to see and clean. (See photo at right.)
Mix hydrogen peroxide and water
Towel under child's neck

Cleaning

  • Suction the trach before cleaning the site.This might help decrease mucus during the cleaning process. See “Do You Know…How to suction a trach.”
  • Put on your non-sterile gloves.
Check the stoma
  • Check the stoma (skin opening) for signs of infection, such as redness, swelling, bleeding, skin breakdown, or discolored drainage (pus). If you see one (1) or more of these symptoms, call your child’s doctor right away. The photo at the left shows a healthy looking stoma with no signs of infection.
  • If you do not see any of the signs of infection above, continue to the next step.
  • If no crusty mucus is present:
    • Use a sterile saline wipe to clean the site.
    • If a wipe does not work, dip a cotton tipped swab in sterile water. Roll the cotton swab between the trach tube and the skin in a circular motion. Use each wipe or cotton swab only one (1) time.
    • Repeat this process until mucus is removed.
Clean around the stoma
  • If crusty mucus is present:
    • Dip a cotton tipped swab in the mixture of hydrogen peroxide and sterile water.
    • Roll the cotton swab between the trach tube and the skin in a circular, outward motion. Use each swab only one (1) time.
    • Repeat this process until crusty mucus is removed.
    • Rinse the area using a cotton swab with sterile water or a sterile saline wipe after the crusts are removed.
    • Dry area with a regular 2x2 gauze pad.
  • If a lot of mucus is present at the stoma even after cleaning, you may place a 2x2 split gauze pad around the trach tube to absorb the mucus. (See photos below.)
Dry area with gauze
Gauze to absorb mucua

Only use a dressing at the stoma site to absorb a lot of mucus or to keep medicine at the stoma site. You must change the dressing whenever it gets wet or dirty. Keeping the dressing changed prevents damage to your child’s skin.

Questions?

If you have questions or concerns about cleaning the trach site, talk to your child’s clinical nurse specialist. A nursing coordinator is always here to answer your questions and address your concerns. Call 901-595-3300 and ask for the nursing coordinator. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 when the call connects.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

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