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The University of Chicago Medicine - Comer Children's Hospital

Home Care

We recommend that children with trachs receive some type of nursing care at home. Before your child is discharged from the hospital, one of our nurse case managers will meet with you to discuss your needs. The case manager is an experienced, registered nurse who arranges for nursing care, equipment, supplies, and other services you may need at home.

Nursing Care

There are two types of home nursing, a visiting nurse or a private nurse. A visiting nurse comes to your home for a short time, usually one or two hours, to provide specific skilled procedures for your child. With private duty nursing, the nurses visit for a longer period of time--usually four to eight hours. Based on your child’s needs and insurance benefits available, the case manager will arrange appropriate home care services.

Equipment Checklist

The case manager can refer you to a company that rents or sells equipment and supplies--called a durable medical equipment company or DME company. Most companies will deliver or ship supplies directly to your home. It is important to remember to reorder supplies at least one week in advance. You should also call your supply company whenever you have problems with the equipment. Before being discharged, you will receive a copy of your child's list.

Workspace at Home

You will need a workspace near your child's bed at home to keep your daily supplies organized. Keep the supplies in a clean, dry place. You will need the following:

  • An extra trach tube
  • One size smaller trach tube
  • Obturator (it comes with the trach tube kit)
  • Ambu bag
  • Suction machine
  • Suction catheters
  • Saline droppers
  • Trach ties and/or Velcro ties
  • Bandage scissors

Care and Cleaning of Equipment

All the equipment must be cleaned to prevent bacterial growth. Bacteria can quickly move down the trach tube and into your child's lungs. The equipment must be cleansed in the following manner:

  1. Wash the equipment with hot, soapy water.
  2. Rinse with hot water.
  3. Rinse the equipment with a solution of vinegar and water.
  4. Air dry.
  5. Store the equipment in airtight container or plastic bag.

Some children with tracheostomies have a limited amount of trach tubes supplied by the insurance company or DME company. In this case, the trach tubes will need to be cleaned and stored for reuse during the month. Please follow the manufacturer’s recommendation for cleaning trach tubes.

Disposable humidity devices may be used for 24 hours. However, if secretions clog the device after coughing, change the device immediately. Throw the old one away. These devices cannot be cleansed for reuse.

Daily and weekly routines for cleaning the trach and equipment will help keep your child healthy.

For daily cleaning:

  1. Rinse connecting tubing of the suction machine.
  2. Empty and clean suction machine bottle and empty the secretions into the toilet.
  3. Clean the trach collar.
  4. Wash the nebulization cup.

For weekly cleaning:

  1. Discard and replace connecting tubing on the suction machine.
  2. Clean the humidity tubing attached to the trach collar.
  3. Wash the exterior of the equipment, the plastic covering of your child's bed and work area with an all-purpose cleaner.

Making Saline

You will need the following supplies:

  • Drinking water
  • Table salt
  • Measuring cup
  • Measuring spoon
  • Two 2-quart pans with lids
  • One quart-size jar and lid
  • Funnel

Follow these steps:

  1. Wash your hands.
  2. Wash pans, spoon, funnel, jar, and lid in soapy water and rinse.
  3. Fill pan with 1 quart (4 cups) plus 1/4 cup of water.
  4. Add two level teaspoons of salt to water.
  5. Bring to a boil. Cover pan.
  6. Boil gently for 10 minutes (start timing after boiling begins).
  7. Place bottle, lid, and funnel in other pan. Cover with water.
  8. Bring to a boil. Cover pan, and boil for 10 minutes.
  9. Let both pans cool to room temperature.
  10. Remove jar from pan. Do not touch inside of jar.
  11. Pour cool saline into jar using funnel.
  12. Place lid on jar. Label jar "salt water."