Clean the stoma and apply new dressing. Maintain sterile technique. The following procedure is very detailed, but this is the bottom line . Explain procedure to patient. Suction patient as necessary.
Place stems at the edge of the sterile field, ready for use.
Maintain sterility of distal end of Q-tip. Maintain complete sterility. Don clean gloves. Remove the inner cannula from the trach tube. Immerse in hydrogen peroxide.