An obturator is a curved rod that fits inside the tracheal cannula, which is a tube inserted into the trachea during tracheostomy.

Tracheostomy is a surgical procedure that creates an opening in the neck and into the trachea, or windpipe, to help a person breathe.

You may need a tracheostomy if you have difficulty breathing due to conditions like:

During the procedure, a surgeon makes an incision in the front of the neck and inserts a tube through it to provide an alternative airway for breathing.

Let’s explore when doctors use an obturator, if you can switch it out yourself, how to use it, potential risks, and frequently asked questions.

illustration of tracheostomy tube components, obturator tracheostomyShare on Pinterest
Tracheostomy tube components. Medical Illustration by Bailey Mariner

Doctors use an obturator during a tracheostomy to ensure the trach tube is correctly inserted and positioned in the airway. It also helps protect nearby tissues, like vocal cords, by supporting the tube as it goes through.

Using an obturator can also reduce the risk of issues if the tube is misplaced, such as accidental removal or inhaling secretions.

Another benefit is that it assists in cleaning the tracheostomy tube. In this situation, a doctor inserts the obturator, cleans the tube, and removes it, helping to prevent infections.

Occasionally, an obturator might be used when removing a trach tube that needs to be replaced or adjusted. The obturator guides the new tube into the correct position while protecting nearby tissues and structures from damage.

It depends. Unless your doctor or nurse instructs you how to change or clean your tracheostomy tube with an obturator, you should not try to do so. Otherwise, it may be dangerous to do so in your situation.

If the medical team determines that you can change it, they will give you the exact instructions and tell you when to do so. It’s a relatively simple process, but being aware of potential risks is essential.

Here is how to use an obturator when changing your tracheostomy tube:

  1. Prepare all the equipment, including the new tracheostomy tube, gloves, protective equipment, and obturator.
  2. Wash your hands well with soap and water.
  3. Have someone with you to help in case anything goes wrong.
  4. Prepare the clean tube by threading the ties through the neck plate opening and inserting the obturator into the outer cannula.
  5. Lubricate the lower part of the tube with water or water-soluble jelly.
  6. Hold the old tracheostomy tube and cut the ties.
  7. Take a deep breath, hold it, and remove the old tracheostomy tube.
  8. Tip your head slightly back and gently insert the new tracheostomy tube with a back and down motion.
  9. Remove the obturator from the outer cannula.
  10. Take a breath and secure the new tube’s ties.
  11. Insert the inner cannula into the outer cannula and lock it in place.

After changing the tube or using an obturator, monitor yourself to see whether you’re coughing or having difficulty breathing. If you feel discomfort or stress when breathing, contact the nearest emergency medical services immediately.

An obturator has many advantages, primarily to avoid complications during tracheostomy care. While it’s generally safe and effective, there are some potential risks to be aware of.

One of the most common risks of using an obturator is the possibility of laceration or trauma to the tracheal wall. This can occur when the obturator is inserted too far into the trachea, or if it’s not removed immediately after insertion.

If you insert the obturator improperly, you may cause damage to surrounding tissues and structures, such as your vocal cords, esophagus, or bronchi. You may also block airflow, which makes it difficult to breathe.

If you do not remove the obturator quickly enough after insertion, it can become lodged in the trachea and further obstruct airflow.

Another common risk is accidental removal or misplacement of the tube. Not having an obturator close by can make it very difficult to adjust, replace, or reinsert the tube again in a short time. This is why your doctor may recommend keeping the obturator at your bedside in case any accidents happen during the night.

Finally, using an obturator increases the risk of introducing bacteria into the airway, which can lead to infection. Ensure that you clean your hands well and that the area where you change or clean your tube is hygienic.

Here are some of the top frequently asked questions about using an obturator for tracheostomy.

Why is the obturator important?

An obturator is essential to tracheostomy care because it helps guide the tracheostomy tube into the airway. It also helps reduce irritation to the airways during insertion or cleaning.

Is a tracheostomy obturator the same as an inner cannula?

Both parts serve different functions. An obturator is a thin, rigid, and curved rod that helps guide the outer cannula into the trachea.

On the other hand, an inner cannula is a part of the tracheostomy tube that fits inside the outer cannula. It can be removed for cleaning or replacement.

Should you keep an obturator at your bedside?

One risk of having a tracheostomy tube is unexpected decannulation. This refers to accidental detachment of the tube, which may make you unable to breathe properly.

You can keep the obturator close by at your bedside to reduce the risk of unexpected decannulation happening at night. This way, you can use it to guide or quickly change the tracheostomy tube into the airway.

An obturator is a necessary tool when caring for your tracheostomy. It helps you change your tube easier without damaging your vocal cords. It can also help prevent infections.

Do not try to use an obturator or change your tracheostomy tube yourself unless your doctor advises you to do so. While it’s a simple procedure, it carries a few risks, such as airflow blockage, if you do not use it properly.