Introduction
A tracheostomy button, also known as a trach button, is a type of artificial airway. It is often the last step in your airway weaning program. It is placed in the opening of the throat where your trach tube used to be. It will help keep your airway open in the event that you need help with mucous or have other breathing problems.
The trach button is made of plastic. It is short, just long enough to cover the distance from the skin to the inside of the tracheal wall.
It has an outer plug that can completely close off the "button" airway and allow you to breathe, talk and cough normally on your own.
The goal is to keep the button plugged at all times or for as long as possible.
Your doctor will decide how soon it can be removed based on your breathing, how your chest sounds and how many hours a day your plug remains in place.
Caring for the Trach Button
Clean the skin around the button at least once a day. Keep the area clean and dry and always wash your hands before touching the button. Drink lots of fluids to keep mucous thin and call your doctor if you have any questions.
Clean the trach button as follows:
- Mix a solution of 1 part normal saline and 1 part hydrogen peroxide in a clean small bowl.
- Wash hands.
- Put on clean gloves.
- Dip cotton tipped applicators (such as Q-tips) in the solution. Using the soaked cotton tipped applicators, clean around the trach button using a sweeping motion in one direction.
- Use one applicator per sweep and then discard.
- Inspect the skin of the entire neck and throat area.
- Look for redness or sores.
- Report skin problems to your doctor right away (during regular office hours).
Suctioning with the Trach Button
If you are not able to clear your airway by coughing, you may suction or use the In-Exsufflator. An adapter will need to be attached to the button so the Ambu Bag or In-Exsufflator can connect securely. (See the Suctioning and/or In-Exsufflator lesson for more information.)
Problems with the Trach Button
What if the button falls out?
If the button falls out, stay calm. Call 911 or your local emergency services.
What if there are problems breathing?
Any of the following can mean that there are problems with breathing:
- Shallow or fast breathing
- Difficulty with speaking
- Crowing noise from the trach button
If breathing problems occur, take the following actions:
Step 1: Unplug the button.
Step 2: Place the palm of your hand over the open button and feel for air. If air is not moving...
Step 3: Look inside the button to see if there is anything blocking the tube.
Step 4: Suction (see Suction section for more information).
Step 5: If this does not help, continue giving extra breaths via the Ambu Bag.
Step 6: Call 911 for help.
Tracheal Plugging
Tracheal plugging is ordered by your doctor to help you wean off an artificial airway. Plugging covers the opening of the trach tube in your throat, and allowing you to breathe through your nose mouth. Plugging will also help make the sound of your voice stronger.
If your lungs need to be cleared of secretions while your trach tube is plugged, try to cough up your secretions or have someone help you to cough with the assisted cough technique that works best for you.
If you cannot clear your lungs, then you will have to be suctioned. If your lungs need to be suctioned, remove the trach plug and always reinsert your inner cannula for suctioning. After suctioning, remove the inner cannula and re-plug your trach tube.
