Cleaning of Tracheostomy Tubes

[Eden, Keryn (DFC)]

Good Morning all,

Seeking you advice.

Disability SA has a number of clients with permanent tracheostomy insitu. (primarily Shiley – plastic tubes) Inner tubes are changed 2 hourly or prn and outer tubes as required given client needs. On changing, the tubes to be cleaned are soaked in a warm tap water solution with sodium bicarbonate and thicker more stubborn secretions are manually removed with a twist of cotton pipe cleaners. The use of the sodium bicarbonate for soaking tubes appears to be historical habit and was present when I commenced here 17 years ago. I have not found any significant evidence base to justify its use for this purpose. Tubes of course are single patient only.

Anecdotal evidence from various other facilities ranges from the use of warm water only, cold water only, a 1:100 solution of detergent. Sodi Bic does not appear to be generally used for this purpose on my search so far. The unit manager advises that they are reluctant to use detergent due to some being ‘heavy handed’ and therefore possibly causing mucosal irritation if rinsing is insufficient.

Can anyone advise whether they are aware of any evidence regarding current best practice for the cleaning of these tubes in a long term care facility with tracheostomy clients also accommodated in community housing? Any links to evidence on the best practice or related articles/policies etc would be greatly appreciated as we are redrawing our clinical procedure for this at this time.

Many thanks and best wishes to all.

Keryn Eden
Occupational Health/Infection Control Nurse
Disability SA – Highgate Park
103 Fisher Street
FULLARTON SA 5063

Wash Wipe Cover ……. Don’t Infect Another

Ph. (08) 8372 1421
E-Mail – Keryn.Eden@dfc.sa.gov.au

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