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Minimize the risk. Protect the caregiver.

Caregiver reminders

For the caregiver, exposure to organisms in circuit condensate poses infection risk. Take precautions to avoid infection during any circuit change.

  • Wash hands before and after manipulating the ventilator circuit, and wear gloves and a mask (when applicable).
  • To avoid getting sprayed by respiratory secretions, disconnect the circuit at a point that positions the tubing away from both the patient and caregiver.
  • Drain the tubing into a secure container.
  • Consider drained condensate (water) as contaminated and treat it as biohazard waste.
  • Also, properly dispose of used equipment, supplies, fluids, and biological specimens to avoid transmitting germs by air or contact.
  • Before leaving the patient, check that all ventilator connections are re-established, and ventilator controls alarm settings, and alarm volume are set properly.

Minimize the risk. Manage the vent circuit.

Exposure to air is not the cause of the lung infections that ventilated patients get.

Here are the most important practices for preventing pneumonia in patients who are ventilated:
  • Practice good hand hygiene with soap and water or an alcohol-based rub before touching the patient or the ventilator.
  • Maintain the patient’s oral hygiene to help prevent bacterial colonization (getting stuck inside) of the tracheostomy tube.
  • Unless there are contraindications, elevate the patient's head about 30-45 degrees to help prevent aspiration of mouth secretions into the lungs.

Doctors or ventilator suppliers may also recommend changing the ventilator circuits at different frequencies. The frequency depends on the circuit manufacturer’s instructions and can range from 48 hours to several days to a month. Check with your doctor or supplier for a recommendation.

Minimize the risk. Monitor the patient.

Ventilator circuit changes

When making any ventilator circuit changes, watch for possible complications related to changing the circuit, including:
  • Displacement of the tracheostomy
  • Equipment failure (from re-establishing connections improperly)

If signs of complications occur, monitor the patient’s vital signs closely. An interruption in ventilator-assisted breathing can adversely affect the patient.

The patient may need to be manually ventilated with a manual resuscitator and oxygen during a circuit change.

Signs of infection

Look for early signs of infection (i.e. fever, change in amount or color of secretions):
  • If the patient gets ill, the breathing tube may need more frequent suctioning.
  • If the patient vomits, shield the tracheostomy tube.
    • If vomit has entered the tracheostomy tube, suction immediately and call your doctor.

Follow your doctor’s advice. Contact your doctor if any signs of infection occur.

Minimize the risk. Maintain the trach tube and inner cannula.

Signs of infection

Caring for the tracheostomy tube and inner cannula is an important part of infection control for an invasively ventilated patient. When applicable, change or clean the inner cannula regularly.

For Your Safety
Watch for these signs of infection and notify your doctor if present:
  • Red, inflamed skin at the stoma
  • Foul-smelling mucus
  • Bright red blood in mucus

Key reminders

If you are unable to remove the inner cannula, don’t force it. Call your doctor.

  • Avoid dust and mold
  • Avoid tobacco and other kinds of smoke
  • Avoid fumes from cleaning solutions such as ammonia or bleach
  • Be careful using any kind of spray product, such as hairspray or furniture polish; you do not want to inhale the mist
  • Keep clothing away from the tracheostomy tube
  • Be sure all caregivers know CPR for tracheostomy patients
  • Post CPR instructions where they will be handy in an emergency
  • Post emergency numbers near the phone

Shiley™ Tracheostomy Adult Homecare Guide

Learn more about infection control and caring for a tracheostomy.

The information and guidance presented on this website is informational only and not intended to influence practice or supersede the instructions for use of any specific device.