Patient Cleaning Instructions

Catheter Cleaning In Place, Immature or Mature Tract

Regular cleaning of your TTO catheter helps ensure its proper function. Cleaning twice daily at 8 am and 4 pm is usual; however, your doctor may prescribe more or less frequent cleanings based on your symptoms.

Review all steps before you begin

  1. Gather the following materials
    • nasal cannula
    • cotton-tipped applicators
    • mild skin soap (e.g. Ivory bar soap)
    • antibacterial soap (e.g. Hibiclens or PhisoHex)
    • sterile saline (e.g. 3-5 ml saline vials or TTS saline) - clean, disposable latex or vinyl gloves
  2. Wash your hands and position yourself in front of a mirror with good lighting.
  3. Put on a nasal cannula, disconnect the transtracheal oxygen hose from the catheter, and connect the oxygen to the nasal cannula. Adjust the oxygen flow rate to the prescribed nasal cannula rate.
  4. Use a cotton-tipped applicator and mild skin soap to clean mucus crusts from around your tract opening. Blot the area dry with tissue.
  5. Put on clean, disposable gloves.
  6. Wash the cleaning rod with antibacterial soap. Rinse it under running water to completely remove all soap residue.
  7. Squirt about 1-2ml of sterile saline into the catheter, ½ of a plastic “bullet,” or two very quick squirts of the TTS saline canister. The squirt of saline may cause coughing.
  8. Run the cleaning rod down the inside of the catheter three times - all the way to the green handle at the end.
  9. Squirt another 1-2ml of sterile saline, the remainder of plastic bullet or two more very quick squirts from the TTS saline canister into the catheter.
  10. Reconnect the transtracheal oxygen hose to both the oxygen source and your catheter and return to your TTO resting flow rate. Remove the nasal cannula. Check to be sure that the SCOOP label on the catheter is upright and readable.
  11. Wash the cleaning rod with antibacterial soap and store it in a clean, dry place.

Cleaning Diagram

Clean mucus from tract opening.

Squirt saline into catheter.

Run cleaning rod down catheter 3 times.

Be sure "SCOOP" label is upright and readable.

Patient Precautions

  1. Do not remove or reinsert your transtracheal catheter while your tract is immature (not fully healed) without the assistance of your doctor.
  2. Although a transtracheal catheter may be cleaned in place, it may also be removed periodically for cleaning (see Removal for Cleaning)
  3. A new cough or increasing shortness of breath in the first few days or weeks of transtracheal oxygen with cleaning in place may be caused by a mucus ball adherent to the catheter. If you think you may have a mucus ball, call your doctor for assistance.
  4. Also call your doctor immediately if you have any of the following problems:
    • Transtracheal catheter comes out before the tract is mature (fully healed)
    • increasing cough or sputum
    • increasing shortness of breath
    • blueness of the lips or fingernails
    • extreme nervousness
    • redness, swelling or pain at the tract opening
    • fever > 99.5 degrees
  5. Replace TTO catheters and hoses every three months. Beyond three months the plastics may begin to yellow and become brittle.  Any TTO product which is brittle, cracked, broken, kinked or develops a yellow-brownish discoloration should be immediately replaced. You should not wait for your doctor or home care provider to remind you to replace your catheters and hose.