_ Prior to discharge from the hospital following your tracheotomy, nursing staff should provide you with care/cleaning instructions. Daily cleaning of your tube is important, which may include cleaning and/or replacing the inner cannula. There are commercially available tracheostomy cleaning kits available which are very helpful in helping with the care of your tracheostomy.
Following the manufacturer’s guidelines for cleaning is important. Always ask your nurse of doctor for proper care instructions as these may vary depending on the tracheostomy tube you have.
_Capping trials refers to times when a “cap” is placed over the tracheostomy tube opening to close off airflow via the tube. In doing so, the tube no longer acts as a means of airflow, allowing respiration entirely through the nose and mouth.
Capping trials may be started using a particular schedule, asking you to wear the cap for specified amounts of time. If this is well tolerated, you will be asked to wear the cap 24/7 for a period of a few to several days. If 24/7 capping is well tolerated, this is a good indication the tracheostomy tube is no longer needed and decannulation can be planned.
Although capping trials provide a good sense of how you will tolerate breathing without the tracheostomy tube, it is important to remember that breathing will be easier following decannulation. If the cap is not well tolerated, and no particular upper airway obstruction is noted. It may be that the tube itself is creating too much obstruction to airflow and you may be down-sized as a result. By placing a smaller tube, and replacing a cap, this will allow for improved airflow around the tube and likely, better tolerance for the capping.