How to remove a tracheostomy tube
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How to remove a tracheostomy tube

Nicola Credland Specialist lecturer practitioner in adult intensive care, University of Hull, Hull, England

Rationale and key points

The decision to remove a tracheostomy tube from the trachea (decannulation) is taken when the patient achieves adequate airway control. This requires a strong cough, minimal respiratory support and an acceptable level of consciousness.

The Glasgow Coma Scale should be used to assess the patient’s level of consciousness.

The patient is suitable for tracheostomy tube removal if their peak expiratory flow rate is more than 60L/minute as measured using a peak flow meter.

Removal of the tracheostomy tube should be delayed if the patient experiences respiratory distress, desaturation or uncontrollable coughing.

Reflective activity

Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

How you think this article will change your practice when managing a patient with a tracheostomy tube.

How this article could be used to educate your colleagues.

Subscribers can upload their reflective accounts at:

Nursing Standard. 30, 9, 34-35. doi: 10.7748/ns.30.9.34.s43


Peer review

All articles are subject to external double-blind peer review and checked for plagiarism using automated software.

Received: 27 July 2014

Accepted: 11 September 2014