Living With a Tracheostomy

Comprehensive NHS guide to home tracheostomy care, suctioning, tube changes, and communication.

Clinical guidance on community/home tracheostomy care for adults.

Suctioning clears airway secretions and keeps the tube patent. Use a clean technique, wash your hands before and after, and insert the catheter only to the length your care team has shown you: the trachea lining is sensitive and can be damaged if the catheter goes too far or suction is applied too long.

Ties secure the tube and are usually changed daily or whenever soiled. Tension should allow one finger to slip comfortably between the tie and the neck, not tighter, not looser. Tape/tie changes are a two-person job: one holds the tube steady while the other changes the tie.

Full tube changes (commonly monthly for silicone tubes, but follow your own schedule) need two trained people and careful preparation. Avoid changing a tube immediately after a meal.

Check the skin around the tracheostomy opening daily for redness or irritation, use a protective dressing behind the tube flange, and change it regularly. Don't apply creams near the stoma without your nursing team's specific approval. It's normal for a new stoma to look red and slightly inflamed for about the first week.

Speech can be affected at first, and usually improves with speech therapy input over time. Options your team may introduce include speaking valves, sign language, or an electrolarynx device, depending on the type of tracheostomy and your individual situation.

Many people can eat normally with a tracheostomy but should be monitored, particularly early on. Suction before meals where possible, and avoid suctioning immediately after eating to reduce the chance of vomiting.

Keep water below the level of the tube, avoid splashing directly onto the stoma, and keep a manual suction option nearby. For hair washing, lean the head back in shallow water or use a shampoo shield your care team recommends.

Secretions change colour, become thicker, increase noticeably in amount, develop an odour, or show blood specks; the skin around the stoma becomes increasingly red, sore or swollen; or you notice new difficulty breathing that isn't resolved by routine suctioning.

⚠️ If you have severe bleeding, sudden severe pain, chest pain, difficulty breathing, or any sign of a medical emergency, call your local emergency number immediately: 000 (AU) · 999 (UK) · 911 (US & Canada) · 112 (EU). A blocked or dislodged tube causing breathing difficulty that doesn't resolve with your usual emergency steps (as shown to you by your team) needs urgent emergency care.

Support resources for colostomy and ileostomy care.

Care tips and support for a peripherally inserted central catheter.

A carer's guide to helping a loved one through recovery.

Mental health support, crisis lines, and patient advocacy resources.