trach care with No inner canula


I work in a smaller community hospital in the Chicago Area. Usually I have pts with disposable shileys or reusable inner cannulas.

Lately we have had pts with trachs with NO inner cannula. I ask, how do we clean those? I am told that we just clean around the site.

No one really gave me a clear answer. It doesnt really specify in our policy. And I cannot find it online.

One more question. To clean an inner cannula, do you use Sterile or Aseptic technique?

I clean inner cannulas with hydrogen peroxide and sterile water or saline. And I clean around the site with mild soap and water and barrier (non alcohol), and then place a 4x4. On some sites I came across said you can clean inner cannula with tap water. Sterile or clean gloves? I always have used clean.



38,333 Posts

Your description describes how we do it in the home. I had a client that didn't want trach care at all because she felt that when the RT did it, that was sufficient. The RT removed the permanent, non-cannulated trach, on a regular basis. I guess he did trach care at the time he changed the trach. If a new trach, though, in the hospital, I would do sterile trach care. There should be a standard order or policy in your unit.


170 Posts

Specializes in MICU/SICU.

I use sterile technique, but I am told that long term trach patients often clean them using clean technique at home.


59 Posts

Has 5 years experience.

A trach with no inner cannula is quite dangerous. What would you do if it occluded? When an inner cannula occludes all you have to do is remove it, and the pt. can breathe. Also, like you are asking, how do you clean a trach without it? Get your hospital to order inner cannulas for these pts.

As for cleaning, there are studies out there that show no clinical significance difference between clean and sterile technique.

To clean, use saline, as hydrogen peroxide is hard on tracheal tissue. Tap water is a bad idea as it can contribute to bacteria growth.


48 Posts

Specializes in Interventional Cardiology, MICU. Has 10 years experience.

I was taught sterile technique, that's our hospital policy..