A tracheostomy collar is a medical device providing specialized respiratory support for individuals who have undergone a tracheostomy, a procedure that creates an opening (stoma) in the windpipe (trachea) to aid breathing. The device wraps around the patient’s neck, covering the stoma. Its primary function is to manage the air entering the airway, not to secure the tracheostomy tube (which is held by ties or holders). The collar helps deliver humidified air or supplemental oxygen directly to the patient’s lower respiratory system.
The Primary Role of the Collar
When a tracheostomy tube bypasses the nose and mouth, the air entering the trachea is often too cool and dry, as the natural warming and moistening functions are lost. This dry air causes the body to produce thicker, stickier mucus, which can dry inside the tube and lead to complications.
The main therapeutic role of the tracheostomy collar is to introduce moisture and warmth back into the inspired air. It connects to an external humidification system, such as a nebulizer or a heated humidifier, which generates a fine mist. This mist is directed into the airway, keeping the mucus thin and loose so it can be easily cleared by coughing or suctioning. Maintaining this moisture prevents the formation of mucus plugs, which can block the tracheostomy tube.
The collar also serves as an efficient delivery system for supplemental oxygen when required. Oxygen tubing connects directly to the collar, providing a controlled and consistent concentration of oxygen right at the stoma. This method ensures the patient receives prescribed oxygen levels without the discomfort associated with a traditional oxygen mask. Managing moisture and oxygen delivery reduces irritation to the tracheal lining and helps prevent respiratory infections.
Key Components and Design
The design of the tracheostomy collar focuses on comfort and functionality. The device consists of a soft, adjustable neckband that secures the collar portion around the stoma. This neckband is often made of hypoallergenic, breathable fabric and fastens with Velcro or fabric ties to accommodate various neck sizes.
The core part is the “collar” or “mask” section, a lightweight plastic shell or cup that fits loosely over the tracheostomy tube flange and the stoma site. This shell features a port, usually a standard 22-millimeter fitting, to which the oxygen or nebulizer tubing is attached. The collar’s shape creates a small reservoir of humidified air or oxygen around the tube opening.
The collar’s design allows humidified air or oxygen delivery while permitting the patient’s exhaled air to escape easily through vents or the open bottom of the shell. This open design prevents the buildup of carbon dioxide, which is a risk if the device seals too tightly. The soft fabric neckband provides stability and comfort while minimizing contact with the skin around the stoma.
Proper Fitting and Application
Correct fitting of the tracheostomy collar is necessary to ensure therapeutic benefits without compromising patient safety. Before application, the neckband should be threaded through the flanges (openings) on either side of the tracheostomy tube. These flanges rest flat against the neck, stabilizing the tube.
Once the neckband is secured to the flanges, the collar is positioned so the plastic shell covers the stoma opening. The neckband is then fastened around the back of the neck, typically using Velcro. The fit must be snug enough to prevent shifting but not so tight that it restricts circulation or causes pressure sores. To confirm a stable, non-restrictive fit, two fingers should comfortably slide between the neckband and the patient’s neck.
After fitting, the oxygen or humidification tubing must be connected to the dedicated port on the plastic shell. Check for any air leaks around the edges of the collar, as leaks reduce the concentration of delivered oxygen or humidity. Finally, inspect the skin underneath the collar immediately after application to identify any potential rubbing or irritation.
Routine Cleaning and Maintenance
A strict cleaning protocol is important to prevent the introduction of bacteria into the airway and subsequent respiratory infections. The collar, especially the plastic shell and neckband, should be cleaned daily, as they collect moisture, mucus, and skin secretions. Components are typically scrubbed gently using a mild soap and water solution or a prescribed cleaning agent.
After cleaning, the collar must be thoroughly rinsed with clean water to remove all soap residue, which could irritate the skin or airway. Allowing the collar to air dry completely on a clean surface is essential, as remaining moisture encourages microbial growth. Having a second, identical collar available is helpful so one can be worn while the other is cleaned and dried.
The soft neckband should be inspected regularly for signs of wear, fraying, or soiling that cannot be removed by washing. The plastic shell needs to be checked for cracks, stickiness, or deformation, as these issues compromise the fit and effectiveness of oxygen or humidity delivery. Healthcare providers recommend a replacement schedule, but the collar should be replaced if it shows visible deterioration or if the material’s integrity is compromised.