Tracheostomy Tube Care With a Reusable Inner Cannula

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There are several kinds of tracheostomy (tray ke OS toe me), or “trach” tubes. The type of trach tube your child has depends on the reason he needs the trach. If your child’s trach tube has an inner cannula, it will need to be cleaned at least 2 times every day. If your child has a lot of secretions, it will need to be cleaned more often in order to remove the secretions.


Gather together all equipment and supplies. Have an extra clean inner cannula on hand to replace a plugged inner cannula.

  • A clean inner cannula
  • Disposable tracheostomy care kit or

-         2 clean or sterile bowls

-         Hydrogen peroxide

-         Sterile water

-         Brush or pipe cleaners

-         Tongs or tweezers

-         Gloves

-         Several sterile gauze packets - one to store cleaned inner cannula

  • Suction catheter

How to Change the Inner Cannula

  1. Wash your hands.
  2. Prepare a clean surface for your supplies.
  3. Open the trach care kit or arrange your supplies on the clean surface.
  4. Pour the same amount of hydrogen peroxide and sterile water into one of the bowls to make half-strength hydrogen peroxide.
  5. Pour sterile water into the second bowl.
  6. Remove the inner cannula by holding the neck plate of the trach tube firmly with one hand.
  7. With your other hand turn the inner cannula ¼ turn to the left (Picture 1). This is the 9:00 position on a clock.
  8. Gently remove the inner cannula.
  9. Place it in the basin holding the half strength hydrogen peroxide.
  10. Immediately put the clean inner cannula into the trach.
  11. Turn the clean inner cannula so the blue dots line up to lock it in place (Picture 2).

Do your child’s usual stoma care, replacing the trach ties and suctioning as needed. Clean the inner cannula that you removed with the one-half strength hydrogen peroxide. Use the brush or pipe cleaners to remove secretions. Rinse the inner cannula in the sterile water.

Use the tweezers or tongs to take the cleaned inner cannula from the sterile water. Place the clean inner cannula into a sterile gauze package. Tape it closed. Use this for the next change. Be sure the blue dots are lined up with each other.

 Tracheostomy Tube Care With a Reusable Inner Cannula (PDF)

HH-II-191              08/11, Reviewed 06/19 | Copyright 2011, Nationwide Children’s Hospital