Respiratory Cloud Clinical Skills Library

Clinical knowledge review

Contraindications

Use these educational prompts with current orders, protocols, patient assessment, facility policy, and supervising-clinician direction.

Skill

Tracheostomy Care - Cleaning and Inner Cannula

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Contraindications Conditions identified as reasons to avoid or defer the procedure pending authorized clinical review. View list Relative contraindications Factors requiring individualized risk-benefit assessment, added precautions, or a modified approach. View list

Contraindications

Review these conditions before proceeding and follow current orders, protocols, facility policy, and supervising-clinician direction.

  • Do not remove a nonremovable inner cannula or perform nonurgent manipulation of a fresh or unstable tract without the required experienced assistance and rescue plan.

Relative contraindications

Use individualized risk-benefit assessment, added precautions, or a modified approach as authorized for the patient and setting.

  • Active bleeding, marked skin injury, suspected infection, loose or displaced tube, or a high-risk fresh tract requires additional personnel and modification of routine care.

Sources

Supporting sources include peer-reviewed research, evidence-based clinical practice guidelines, professional standards, and foundational respiratory care references, as applicable to the skill.

  1. Mussa CC, Gomaa D, Rowley DD, et al. AARC Clinical Practice Guideline: Management of Adult Patients with Tracheostomy in the Acute Care Setting. Respir Care. 2021;66(1):156-169. doi:10.4187/respcare.08206. PMID:32962998.
  2. Volsko TA, Parker SW, Deakins K, et al. AARC Clinical Practice Guideline: Management of Pediatric Patients With Tracheostomy in the Acute Care Setting. Respir Care. 2021;66(1):144-155. doi:10.4187/respcare.08137. PMID:33380501.