Dr. C.R. asks, “What kind of home supplies do my tracheostomy patients need?”
Answer: Patients need many supplies to manage their tracheostomy. They need plenty of suction catheters, suction machine, tubing, inner cannulas (if disposable), tracheostomy cleaning kits, trach holders, and an extra trach of the same size, and one size smaller. It is essential that these supplies are delivered to the patients home before the patient is discharged.
Keep in mind that Medicare and most insurance companies provide a cap on the number of supplies. For example, the maximum allowance for suction catheters is 90 per month. The patient can use the same suction catheter all day by rinsing it completely and allowing it to dry between uses. But this may not be optimal, especially if the patient is prone to frequent infections. In that case, it would be wise to write a letter of medical necessity so that they can receive more than the usual maximum number of supplies.
Maximum monthly allowance for other tracheostomy supplies are as follows: one new tracheostomy tube, 12 rigid Yankauer suction catheters, 30 disposable inner cannulas, 30 tracheostomy holders, and 30 cleaning kits per month.
Patients need to be taught how to use these supplies before they are discharged from the hospital so that they are comfortable with the basic care of the tracheostomy. This includes suctioning, changing or cleaning the inner cannula, care of the stoma, and managing the cuff (when present). They also need to know how to identify the signs of infection and how to manage an emergency, such as a mucus plug.