how to change inner cannula of trach

3 min read 07-02-2025

Meta Description: Learn how to safely and effectively change a tracheostomy inner cannula with our comprehensive guide. We cover preparation, the step-by-step process, post-procedure care, and troubleshooting common issues. This detailed guide ensures you're equipped to handle inner cannula changes confidently.

Understanding Tracheostomy Inner Cannulas

A tracheostomy, or trach, is a surgical opening in the neck that allows air to enter the lungs. Many tracheostomy tubes have an inner cannula, a smaller tube that fits inside the outer cannula. This inner cannula can be removed and cleaned or replaced, helping to maintain a clear airway and prevent infections. Regular inner cannula changes are crucial for patient hygiene and respiratory health. This guide is for informational purposes only and does not replace professional medical training. Always follow your healthcare provider's specific instructions.

Preparing for Inner Cannula Change

Before beginning the procedure, gather all necessary supplies. This includes:

Clean gloves: Essential for maintaining hygiene.
Sterile saline: Used for rinsing and cleaning.
New inner cannula: Ensure it's the correct size and type for your patient's trach tube.
Suction catheter: To clear any secretions before and after the change.
Trach ties or tape: Secure the new inner cannula.
Sterile gauze pads: For cleaning and absorbing secretions.
Oxygen source: Have oxygen readily available in case of difficulty.
Extra trach tube: In case of an emergency.

Assessing the Patient

Check the patient's oxygen saturation levels (SpO2) before starting. Note their respiratory rate and effort. Any signs of respiratory distress necessitate immediate medical attention.

Step-by-Step Guide to Changing a Tracheostomy Inner Cannula

1. Hand Hygiene and Preparation: Perform thorough hand hygiene and don clean gloves. Explain the procedure to the patient, if possible, to reduce anxiety.

2. Suctioning: Gently suction the patient's airway to remove any visible secretions. This helps improve visibility and prevents accidental aspiration.

3. Removing the Inner Cannula: Using sterile forceps (if necessary), carefully grasp the inner cannula's obturator (if present) or the cannula itself. Gently remove the inner cannula, holding a sterile gauze pad underneath to catch any secretions.

4. Cleaning the Outer Cannula: Use sterile saline to gently clean the outer cannula. Use a sterile brush, if available, to remove any stubborn secretions or crusting. Never insert anything into the tracheostomy tube beyond the length of the outer cannula.

5. Cleaning the Inner Cannula (If Reusable): If the inner cannula is reusable, clean it thoroughly with sterile saline and a brush. Rinse it well and allow it to air dry completely before reinserting. If disposable, discard it.

6. Inserting the New Inner Cannula: Carefully insert the new inner cannula into the outer cannula. Ensure it is fully seated.

7. Securing the Tracheostomy Tube: Secure the trach tube in place with fresh ties or tape, ensuring it is snug but not too tight, allowing for comfortable breathing.

8. Post-Procedure Care: Reassess the patient's SpO2, respiratory rate, and breathing effort. Observe for any signs of bleeding, respiratory distress, or discomfort.

9. Documenting the Procedure: Record the time and date of the cannula change, along with any observations.

Troubleshooting Common Issues

Difficulty Removing the Inner Cannula: Use sterile saline to loosen any secretions. If stuck, seek assistance from a healthcare professional.
Accidental Decannulation: Remain calm, and immediately cover the stoma opening with a sterile gauze pad or a sterile gloved hand to prevent airway obstruction. Call for immediate medical assistance.

When to Seek Medical Attention

Contact your healthcare provider immediately if you experience any difficulties during the procedure, if the patient shows signs of respiratory distress, or if there's any unexpected bleeding.

Remember, proper training and consistent practice are essential for safely changing a tracheostomy inner cannula. This guide serves as a helpful resource but does not substitute professional medical guidance. Always consult with a qualified healthcare professional for personalized instruction and guidance related to your specific situation.