Care Before Tracheostomy Tube Removal (Decannulation) Before removing a tracheostomy tube, careful preparation and assessment are essential to ensure patient safety. The patient should be clinically stable, alert, and breathing adequately without ventilator support. Oxygen saturation must remain stable on room air or minimal oxygen, and the patient should have an effective cough with minimal secretions. The tracheostomy site and surrounding skin should be healthy, with no signs of infection. As