Care & recovery · Airway
Tracheostomy Care
Caring for a tracheostomy at home becomes routine with practice, but two things matter most: keeping the airway clear, and knowing exactly what to do if breathing becomes difficult. Keep your emergency kit within reach at all times.
In an emergency — act now
What it is
A tracheostomy is a small opening (a stoma) made in the front of the neck directly into the windpipe (trachea). A short tube sits in the opening so air passes straight to the lungs, bypassing the nose and mouth.
Why you have it
It may be needed to bypass a blockage in the upper airway, to make long-term breathing support easier, to help clear secretions from the lungs, or to protect the airway after certain surgeries or illnesses.
Day-to-day care
- Suction when needed, not on a fixed clock — when you hear rattly or bubbly breathing, see secretions, or the person signals for it. Use clean technique and suction only for a few seconds at a time.
- Add humidity. The tube bypasses the nose, which normally warms and moistens air, so secretions dry and crust without help. Use the heat-moisture exchanger ("Swedish nose"), saline drops or a humidifier as your team advised.
- Clean the inner tube (inner cannula) as instructed — often a few times a day — to stop it crusting and narrowing. Many are simply removed, cleaned and re-inserted, or swapped for a clean one.
- Care for the stoma and skin. Clean around the opening with saline and check the skin for redness or soreness. Change the dressing and ties when damp or soiled.
- Check the ties are snug but not tight — you should fit one finger underneath. Too loose and the tube can fall out; too tight is uncomfortable and marks the skin.
- Protect the airway from water, dust, sprays and loose fibres. Cover the stoma loosely (never airtight) outdoors, and take great care in the shower — water must not get into the tube.
When to call your team
- Breathing is getting harder, faster or noisier even after suctioning — if it's severe, use the emergency steps above.
- Secretions turn green, yellow, smelly or bloody, or there's a fever — signs of a chest infection.
- The skin around the stoma is red, swollen, sore, bleeding or weeping.
- Bleeding from the tube or stoma beyond a light streak.
- You're struggling to pass the suction catheter, or the inner tube keeps crusting up quickly.
Frequently asked questions
Why does suctioning matter so much?
Because the tracheostomy bypasses the nose and mouth, secretions build up in the tube and lungs and aren't easily coughed out. Suctioning clears them so the airway stays open — it's the single most important daily skill.
Can someone with a tracheostomy still talk?
Often yes, depending on the tube. A speaking valve, or covering the tube only if your team has confirmed it's safe, lets air pass over the voice box. Your speech therapist will guide what's right for you.
What if I see crusting in the tube?
Crusting means the air is too dry. Increase humidification, use saline drops as advised, and clean the inner tube more often. Heavy crusting that narrows the airway needs your team's attention.
Can the person shower or wash their hair?
Yes, with care to keep water out of the tube — a handheld shower aimed away from the neck, a stoma cover, and leaning back for hair washing. Never let the stoma go underwater.