Introduction to Tracheostomy Care

A tracheostomy is a surgically made opening, called a stoma, in the front of the neck into the windpipe, with a tube placed in it. Air then goes in and out through the tube instead of the nose and mouth. This lesson explains why people have a tracheostomy and the main parts of the tube. Key points: reasons include long term ventilation, a blocked or narrowed upper airway, and difficulty clearing secretions; tubes have a flange and ties, and may have an inner cannula and a cuff; and each person's tube type and size are recorded in their plan.

Tracheostomy management is one of the high intensity daily personal activities in the NDIS Practice Standards, and the NDIS Commission's High Intensity Support Skills Descriptors describe, in general terms, the knowledge and skills workers need. This lesson explains what that means for you. Key points: this course is an introduction and builds knowledge only; tasks such as suctioning, inner cannula care, tie changes and tube changes need specific training; you must be trained and assessed as competent for each participant by a qualified health practitioner; and you must follow the tracheostomy and emergency plans exactly.

The nose normally warms, moistens and filters the air we breathe. With a tracheostomy, air goes straight into the windpipe, so it must be humidified in another way. This lesson covers humidification and secretion care in general terms. Key points: humidification may use a heat and moisture exchanger on the tube or a humidifier; dry air thickens secretions, which can block the tube; watch the amount, colour, thickness and smell of secretions; support hydration as the plan allows; and only suction if you are trained and signed off.

Day to day tracheostomy care focuses on keeping the stoma clean, keeping the tube secure and preventing anything entering the airway. This lesson covers these in general terms, along with supporting communication. Key points: clean around the stoma as the plan directs and check for redness, swelling or discharge; tie changes usually need two trained people; keep water, powders, fluff and small items away from the stoma; clothing should not cover or block the tube; speaking valves are only used as the plan directs; and the person's communication method must always be within reach.

The two most serious tracheostomy emergencies are a blocked tube and a dislodged tube, where the tube comes partly or fully out of the stoma. This lesson covers the signs of an airway problem and the emergency equipment that must always be with the person. Key points: signs include difficulty breathing, noisy or bubbly breathing, colour changes, distress, a ventilator alarm, and the tube looking displaced; the emergency kit usually includes spare tubes including one smaller size, suction equipment and spare ties; and the kit must go wherever the person goes and be checked every shift.

In a tracheostomy emergency, fast action saves lives. This lesson describes a general response, which the person's emergency plan and your participant specific training will make exact. It does not replace a nationally accredited first aid certificate. Key points: call triple zero early and say the person has a tracheostomy; follow the emergency plan; only trained workers use the emergency equipment; if the person is unresponsive and not breathing normally, start CPR, with rescue breaths given as the plan and your training direct; hand over to paramedics; and report and debrief afterwards.

This case study follows Zara, a young woman with a tracheostomy who is going on a day trip to the beach with her support worker. The lesson shows how planning an outing with a tracheostomy works in practice: checking the emergency kit, portable suction and communication aids, planning for sand, wind, water and heat, and making sure a trained worker is present at all times. It explores what to do when something important is left behind. Key points: the kit goes everywhere, plan for the environment, and the outing goes ahead safely or not at all.

This case study follows Mr Haddad, an older man who lives at home with his wife and has had a long term tracheostomy since treatment for throat cancer. Over two days his support worker notices his secretions changing colour and amount, and that he seems more tired and breathless. The lesson shows how to observe, record and report changes early, how to support comfort within the plan, and when a change becomes an emergency. Key points: know the person's normal, report changes early, and treat breathing difficulty as urgent.

This case study is set during a night shift in a supported home. A resident with a tracheostomy becomes distressed and his worker finds the tube has come out of the stoma. The lesson walks through the emergency response: calling for help and triple zero, following the emergency plan, and the role of trained staff and the emergency kit. It then looks at what happens afterwards, including handover, incident reporting and support for workers. It finishes by bringing together the key messages of the whole course. Key points: act fast, follow the plan, and report and review afterwards.