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The nose and mouth warm, moisten, and filter the air we breathe as the air travels into the lungs. If you have either a laryngectomy or tracheostomy, this system is by-passed. You may have trouble keeping your airway moist. This may cause a dry irritated airway known as tracheitis.
This handout is to help you prevent tracheitis, coughing spells, and thick secretions. Thick secretions are hard to cough up and could plug your airway. This is extremely important because a plugged airway can be a life-threatening condition.
If you live in a cold climate, you need to add humidity to the air. Heat sources can rob moisture from the air in your home making it harder to breathe.
Ways to Increase Humidity
Place a large capacity (9-10 gallon) room humidifier in the main living area. When prescribed by a doctor, some health insurance will pay for the humidifier. Check with your insurance company.
Place a small vaporizer at the bedside to add moisture at night.
Place shallow pans of water on top of the radiator at home. This is an easy and low-cost way to add moisture to room air.
For newer home heating systems, change your built-in humidistat to 45-50%. Use a low-cost gauge to keep the level at 50%. These can be found at a hardware store.
Make a steam-filled bathroom. This is most helpful for clearing thick secretions. Turn hot water on in the shower and close the bathroom door.
Let the room fill with steam. Breathe in the moist air.
Use a home “mist” machine or nebulizer. Some insurance cover the cost if prescribed by your doctor. You can get this machine from a medical supply vendor. Check with your insurance company.
Protect the stoma or trach tube. Use gauze, a stoma cover, a crocheted bib, or other lint-free material. This helps humidify and warm the air that is breathed in. Especially when going outside during the colder months.
If you are a Total Laryngectomy patient, wear your HME and change daily.
Over the counter products such as Ocean, Ayr Saline Nasal Mist, and Salinex can also be used. You should use a saline only product. Watch labels if you buy these over-the-counter products. The tiny, pre-filled spray bottle can be carried in your pocket or purse and be refilled. It is a handy source of humidity. You may mist your trachea or stoma every 1–2 hours, if needed.
Living in colder climates may increase the need to use saline as often as every two hours. You can make normal saline at home.
Homemade Saline Recipe
Boil 1 quart of water for 5 minutes, allow to cool to room temperature.
Add 1 ½ level teaspoons of non-iodized salt per quart of water.
Because germs can grow in the solution, discard unused homemade saline mix after 24 hours.
Other ways to prevent tracheitis include:
Staying on top of your immunizations especially influenza, COVID, and pneumococcal as prescribed by your provider.
Caring for your tracheostomy or stoma daily as you were instructed to do in the hospital.
Taking preventative measures to prevent respiratory infection such as avoiding sick contacts with respiratory symptoms.
Drink plenty of liquids. Drinking 6-8 eight-ounce glasses of liquids a day can help keep the secretions thin.
When to Call
Change in appearance of secretions i.e., presence of blood, pus, green/yellow color.
Presence of a fever of more than 100.4 on two readings four hours apart.
Call 911 if you:
Have difficulty breathing.
Have sudden, new, noisy breathing.
Have a bluish tint to lips or fingernails.
You cannot clear mucus from the trach/stoma.
Who to Call
Monday – Friday, 8:00 am – 5:00 pm
After hours, this number will be answered by the paging operator. Ask for the ENT doctor on call. Leave your name and number with area code. The doctor will call you back.
Toll-free number: 1-800-323-8942.