You will need the following supplies:
- A person to assist you
- Tracheostomy ties or velcro trach ties
- Blunt-end bandage scissors
- Gauze trach dressing (trach sponges)
- Blanket or towel roll
- Warm soapy cloth
Follow these steps:
- Wash your hands.
- Before changing the tracheostomy ties, suction your child. Suctioning will remove the mucus and decreases the chances of coughing which may lead to coughing out the trach tube during the procedure.
- Cut the tracheostomy tie long enough to fit twice around the neck and add 3 to 4 extra inches. Or assemble the Velcro trach ties per package instructions.
- Place a blanket or towel roll under your child's shoulders. This will extend his or her head backward and allow you access to the tracheostomy ties. Hold your child securely and safely. If your child cooperates, the procedure can be done while your child is sitting up.
- Have your assistant stabilize the tracheostomy by holding the phlanges securely to the neck.
- Cut the old tracheostomy ties with blunt-end bandage scissors near the knot. Thread the new ties through the hole in the phlange.
- If using Velcro ties, remove old Velcro ties and thread the new ties through the phalange.
- While your assistant secures the trach, bring your child slightly forward and remove the old tracheostomy ties.
- Cleanse the back of the neck with a warm soapy cloth. Then rinse and dry thoroughly.
- Bring the new ties to the back of the neck. Make sure the ties lie flat and are not twisted. Thread the ties through the other phalange hole. Tie one square knot. If using Velcro ties, thread the Velcro through the other side of the trach and secure the Velcro per manufacturer
- To make sure the ties are tight enough, you should be able to place only one finger between the ties and the neck. If they are too loose or too tight, adjust and check again.