##  [Tracheostomy Care](/tracheostomy-care-0) 

 Definition

A tissue integrity concept defining assessment and care practices used to prevent, treat, and monitor wounds and skin breakdown. It governs risk identification, dressing selection, offloading, monitoring, and documentation of healing progress. It does not ensure healing without appropriate underlying management and consistent care execution. It materially affects comfort, infection risk, and recovery trajectory through timely prevention and evidence-based treatment. The concept is generally stable, though products and best practices evolve over time.



 

 

 

 

 

 





## Principle

Principle

Preserve airway patency and patient ventilation while preventing infection, tube displacement, mucosal injury, and skin breakdown at the stoma; interventions must balance humidification, secretion clearance, and device security.

 

 

 

 

 





## Demonstration

Demonstration

A patient with a new tracheostomy: the nurse performs hand hygiene, dons appropriate PPE, removes and cleans the reusable inner cannula with sterile technique, inspects the stoma for erythema or granulation, adjusts sutures and ties to secure the tube without over-tightening, checks cuff pressure to prescribed range, provides humidified oxygen, and performs gentle suctioning when secretions impair breathing.

 

 

 

 

## Misapplication

Misapplication

Routinely forcefully suctioning to the carina or using nonsterile technique for inner cannula cleaning; manipulating the tube without a second trained clinician present during early postoperative care—both can cause mucosal trauma, infection, accidental decannulation, or respiratory compromise.

 

 

 

 

 





## Consequence

Consequence

When performed correctly, tracheostomy care maintains effective ventilation, reduces local infection and skin breakdown, preserves stoma integrity, minimizes emergency decannulation, and supports patient comfort and ability to communicate and swallow as appropriate.

 

 

 

 

## Reversal

Reversal

Neglecting tracheostomy care or performing unsafe manipulations results in tube occlusion, aspiration or airway obstruction, local infection with cellulitis or granulation, emergency decannulation, and potential respiratory failure.

 

 

 

 

 





## Boundary

Boundary

Applies specifically to care of tracheostomy tubes and peristomal tissue in patients with tracheostomies (temporary or permanent). It does not include routine care of endotracheal tubes in intubated patients in the operating room, elective surgical placement techniques, or noninvasive airway support.

 

 

 

 

 





## Semantic Tension

Semantic Tension

Often conflated with basic suctioning or general wound/stoma care; tracheostomy care uniquely combines airway management, secretion clearance, device mechanics (cuff, inner cannula), and stoma skin care rather than treating these elements separately.

 

 

 

 

 





## Synthesis

Synthesis

Tracheostomy care is the coordinated set of airway, device, and stoma maintenance tasks that keep a tracheostomy functional and safe—balancing humidification, secretion management, securement, and infection prevention to preserve breathing and tissue integrity.