If you are a family caregiver for a loved one with a tracheostomy, few routines feel more personal than changing the trach ties that hold the tube in place. Done well, a tie change is quick, calm, and uneventful. Done poorly, it can compromise the airway, irritate the skin, or send you to the ER. This guide walks through the steps, the supplies you will need on hand, and how Arkansas Medicaid covers your routine trach supplies through providers like Finnegan Health Services so you never run short at the wrong moment.
Why trach ties matter more than people think
Trach ties and tracheostomy tube ties are the soft straps that secure the trach tube against the neck. They keep the tube from shifting during coughing, suctioning, swallowing, and sleep. A tie that is too loose allows micro-movement that can create a false passage or a decannulation event. A tie that is too tight causes skin breakdown, pressure sores, and discomfort that can make a patient dread the next change. Most clinicians recommend changing trach ties at least once a day, and immediately if they become wet, soiled, or stretched out. Have a second set of trach ties and trach straps within arm’s reach of the patient at all times.
Recommended supplies for routine tracheostomy suctioning and tie changes
Before you begin, gather everything on a clean surface within reach. The core list for a routine tie change is short: a fresh pair of trach ties or tracheostomy tube ties, a trach tube of the same size in case of emergency, a suction catheter, a working suction machine with tubing and canister, a bowl of clean water, scissors, and a flashlight for visualizing the site. Most caregivers also keep a yankauer, spare inner cannulas, and a few gauze pads on the tray. The same supply set covers the suctioning you will do right after the tie change, which is the part of the routine where having the right equipment is the difference between a 10-minute task and a 20-minute scramble.
How to change trach ties, step by step
- Wash your hands thoroughly and explain the steps to the patient, even if they are non-verbal. Routine is reassuring.
- Suction the trach thoroughly so the airway is clear before you move the tube. This is also the moment many caregivers use to refresh their technique on how to deep suction a trach safely at home, which we cover in more detail below.
- With one hand, hold the trach flange steady against the neck. Do not let go until the new tie is secured. This is the single most important safety habit in the entire routine.
- Unfasten the old tie on one side first, then thread the new tie through that side of the flange and fasten it. Repeat on the opposite side.
- Check tension: you should be able to fit exactly one finger between the tie and the neck. More than that is too loose. Less than that will cause skin breakdown within hours.
- Inspect the skin under the old tie for redness, moisture, or breakdown, and document what you see. This is what your prescribing clinician uses to adjust the care plan.
- Discard the old tie, restock the tray, and note the date and time in the caregiver log.
A tie change typically takes 5 to 10 minutes once you are comfortable. New caregivers should expect 20 to 30 minutes for the first week, which is normal.
How to deep suction a trach safely at home
Deep suctioning is the part of the routine caregivers worry about most, and it is also the part where proper technique protects the airway. Use a clean suction catheter sized for the trach, attach it to the suction tubing, and set the suction pressure to the level your clinician recommended (typically 80 to 150 mmHg for adults, lower for pediatric patients). With the patient taking a slow deep breath, insert the catheter smoothly to the measured depth, then apply suction while withdrawing with a gentle rotating motion. Never force the catheter, and never suction for more than 10 to 15 seconds at a time. Allow the patient to rest and breathe between passes. Flush the catheter and tubing with clean water between passes. If you see blood, increased resistance, or the patient desaturates, stop and call the prescribing clinician.
How Arkansas Medicaid covers your trach ties and supplies
Arkansas Medicaid covers the routine trach supplies a tracheostomy patient needs at home when they are prescribed by a physician and supplied by a participating durable medical equipment provider. The typical monthly allowance includes trach ties, trach holders, and tracheostomy tube ties, suction catheters, suction tubing, canisters, and yankauers in quantities the prescribing clinician specifies. Finnegan Health Services is an ACHC-accredited Arkansas Medicaid supplier that handles the prior authorization, refills, and free doorstep delivery, so the only thing on the caregiver’s side of the workflow is checking the supply shelf and submitting the order before the month runs out. For a closer look at exactly what Medicaid allows each month, see our breakdown of Monthly Trach Supply Allowances Through Arkansas Medicaid.
When to call the clinician
A tie change is not the moment to troubleshoot an emergency. Call the prescribing physician, go to the ER, or call 911 if the trach tube becomes dislodged and cannot be replaced, if the patient has trouble breathing that does not resolve with suctioning, if there is bright red bleeding from the airway, or if the patient shows signs of infection such as fever, increasing secretions, or redness around the stoma. The Finnegan Health Services team can help with supplies and delivery, but we cannot provide medical advice. Your prescribing clinician is the right call for any clinical question.
Restock your routine the easy way
When you are ready to reorder, the fastest path is the Finnegan Health Services online order form, or call 1-888-789-6600 to set up recurring monthly delivery. We keep your trach ties, tracheostomy tube ties, suction catheters, and the rest of the routine trach care kit on a refill schedule that matches your Medicaid allowance, so the supply shelf is full before the month runs out.
