Tracheostomy Maintenance
Tracheostomy care should be performed with droplet-level precautions
(gloves, gown, mask/eye protection) at a minimum. Tracheostomy in
COVID-19 positive patients should utilize closed-circuit suction, heat
and moisture exchanger (HME) if not ventilated, and in-line HEPA
filtration if ventilated. Cuff inflation is preferred in patients with
known COVID-19 disease until viral shedding has subsided. The frequency
of tracheostomy changes should be reduced to every 1-3 months for all
patients, except for down-sizing and cuff related issues that are
determined to be clinically urgent. Tracheostomy changes should be
avoided in COVID-19 positive patients until viral clearance has been
achieved to minimize unnecessary healthcare worker exposure.