The inner tube is a safety feature that sits inside the outer tube of the tracheostomy, and reduces the potential for blockage of the tracheostomy tube.

The inner tube can be easily removed and cleaned, while the outer tube remains in place to keep the airway open.

The inner tube must be present at all times; it may not be possible to provide resuscitation to the patient if the inner tube is absent. The inner tube should be checked every two hours and cleaned as required.

To clean the inner tube:

1. Explain the procedure to the patient.
2. Check the replacement tube is the correct size for the tracheostomy.
3. Remove the inner tube from the tracheostomy, and replace immediately with a clean inner tube. Different tracheostomy tube manufactures have different styles for unlocking and locking the inner tube in place.
4. Place soiled inner tube in bowl of sterile water, and clean with tracheostomy cleaning swabs.
5. Shake off all excess water, dry with gauze squares and store in a dry container with a lid at the patient’s bedside ready to repeat the process.