A tracheostomy is a medical procedure that creates an opening in the neck, leading directly into the windpipe (trachea), to help a person breathe. A tube is inserted into this opening, called a stoma, to maintain an open airway. This article focuses on a routine aspect of tracheostomy care: the inner cannula change, which helps ensure comfort and safety for individuals with a tracheostomy.
What is an Inner Cannula?
A tracheostomy tube typically consists of several components, including an outer cannula, which keeps the stoma open, and an inner cannula. The inner cannula is a removable tube that fits inside the outer cannula, functioning like a liner. Its purpose is to keep the airway clear by collecting mucus and secretions, preventing them from building up and blocking the main tracheostomy tube.
Inner cannulas can be either disposable or reusable. Disposable versions are discarded after use and replaced with a new sterile one, while reusable types are cleaned thoroughly and reinserted. They are commonly made from plastic or silicone and come in various sizes and designs, some featuring fenestrations (small holes) to facilitate speech or reduce the work of breathing. The inner cannula usually has a locking mechanism to prevent it from accidentally dislodging.
Reasons for Routine Changes
Regular changing of the inner cannula is important for individuals with a tracheostomy to maintain a clear airway and promote overall health. Regular changes prevent mucus and secretion buildup, which can block the tube and make breathing difficult.
It also maintains hygiene and reduces infection risk. The airway’s warm, moist environment can foster bacterial growth, and regular changes remove these potential infection sources, promoting respiratory health. Routine changes also ensure comfort by preventing irritation from dried secretions and maintaining optimal airflow. The specific frequency of changes, whether daily, twice daily, or as needed, is determined by healthcare providers based on an individual’s secretion levels and type of inner cannula.
Overview of the Change Process
The process of changing an inner cannula is a routine procedure, typically performed by trained individuals such as patients, caregivers, or medical professionals. It begins with meticulous hand hygiene to prevent the introduction of germs. Supplies, including a new or cleaned inner cannula, are prepared and laid out.
The existing inner cannula is gently unlocked and removed from the outer cannula. If it is a reusable type, it is then cleaned using a small brush and sterile water or saline, often with a soaking solution to loosen secretions. A new or thoroughly cleaned inner cannula is then carefully inserted into the outer cannula, ensuring it locks securely into place. This procedure is designed to be quick and efficient to minimize any interruption to breathing, but proper training is essential for safe execution.
Daily Care and When to Seek Help
Daily tracheostomy care extends beyond inner cannula changes, focusing on stoma cleanliness and monitoring for issues. This includes cleaning the skin around the stoma daily to prevent crust formation and observing for infection signs. Suctioning may be needed if mucus cannot be cleared by coughing; supplies should always be available.
Watch for signs of a problem, such as increased pain, swelling, warmth, or redness around the stoma. Other signs include increased mucus, changes in color (yellow, green, or brown), a foul smell, or persistent coughing. Difficulty breathing after suctioning, or if the tracheostomy tube falls out and cannot be reinserted, requires immediate medical attention. These symptoms indicate a need to contact a healthcare provider promptly to prevent complications.