1. Tracheostomy Cleaning Guidelines (All Information taken from individual manufacturer’s guidelines) Arcadia Cleaning Soak the tube for 60 minutes in warm water with mild detergent (a non perfume soap), to loosen any debris, gently scrub with a soft brush i.e. tracheostomy cleaning brush. A dilute solution of sodium bicarbonate (NaHC03) mixed with water may also be used. A lint free swab or cloth can be used to clean the inside of small tubes. 1.After cleaning thoroughly rinse the tube with clean water, sterile water or sterile normal saline to remove any cleaning solution residues 2. Air dry the tube 3. Inspect the tube for damage prior to use 4. Store the tube and obturator in a clean plastic box with lid or clean sealed bag. Sanitisation (Community only) 1.Remove clean tube from sealed bag or box 2.Place the silicone tracheostomy tube and the obturator side by side in pan of rapidly boiling water. 3.Following immersion, cover the pan with a lid and immediately remove from the heat. 4.Allow to cool before use. Pick up the obturator by the handle and the tracheostomy tube by the neck flange to keep clean 5.Inspect the tube for damage prior to use. 6.Store the tube and obturator in a clean plastic box with lid or clean sealed bag. The tube must be sanitised once a month or after completion of antibiotic therapy. The tube can be sanitised five more times. Shiley Stage 1. 1.The dirty tube should be soaked in ½ teaspoon of sodium bicarbonate (NaHC03) dissolved in ½ pint (280mls) of warm water for 5 minutes, to help loosen secretions inside the dirty tube. Use a disposable container. 2.The tube should then be cleaned inside and out with a tracheostomy cleaning brush ensuring all secretions are removed (use one pipe cleaner per cleaning episode and discard). Take care when inserting the brush as the wire tip could scratch the plastic and this would provide an ideal area for microorganisms to grow. Stage 2. 1.Clean the tube thoroughly with STERILE NORMAL SALINE to remove all traces of the sodium bicarbonate. 2.The cleaned tube should be air dried and then placed in a sterile towel and stored in a clean plastic container with lid. The tube is then ready for the next tube change. Shiley tubes can be used up to 28 days then must be discarded. Bivona Hospital ward or home-care re-processing -Cleaning 1.When the tube is removed place the tube in a sealed plastic bag or container until it is ready to clean. This will avoid drying out and hardening of secretions. 2.Soak the tracheostomy tube and its obturator, separately, in a container of warm water containing a mild soap solution for 60 minutes. Ensure that the wash reaches all parts of the tube. This may mean using a syringe to flush through the talk attachment tube (if fitted) and manipulating small tubes to ensure that the liquid fills the inside of the tube. 3.Remove any secretions with a lint free swab. Small tracheostomy tubes can be cleaned by pulling a small portion of a lint free swab through the tube. 4.Inspect for any residual contamination, if necessary repeat the soak and clean process. 5.Rinse the tube inside and out with clean warm water, flushing thoroughly with water and then air dry. 6.Store in a clean sealed plastic bag or container. Sanitisation Instructions 1.One method of sanitising the product is to place the cleaned tube and obturator in an electric steam disinfector (“baby bottle sterilizer”) e.g. Avent. 2.The sanitization process must be conducted in accordance with the supplier’s instructions for use. The tube and obturator must be taken out of the bag prior to placement in the unit. The obturator must be placed in the unit alongside the tube, not assembled into the tube. Items remain disinfected (if the sterilizer is unopened) for 1 or more hours as stated in the individual manufacturer’s instructions. Alternative Sanitisation Instructions: (community only) 1.Remove the tube and the obturator from its container and place in a pan of rapidly boiling clean water. 2.Cover the pan and REMOVE IT FROM THE HEAT. Allow the water to cool to “hand hot” before removing the parts. 3.Handle the obturator by its handle and the tube by its neck flange. The tube must be sanitised once a month or after completion of antibiotic therapy. The tube can be sanitised five more times. For other brands please refer to manufacturers guidelines Version 1.0.0 Jo Claymore/BCH Tracheostomy Group/ Draft November 2010, can be used in draft form until fully ratified.