If you have ever used a posey style tie you will already know how to use these ties. I prefer this design over many other types simply because I find it more secure. These instructions are for a single person changing the strap. Of course its easier to have help but many of us trach moms have become experts at doing it alone. These instructions are for a baby or small child not yet sitting.
1. Before putting the clean tie on, give the straps a tug to be sure they are secure.
2. I prefer to do one side than the other when it comes to changing the tie. Make sure that at all times you are gently pressing the trach down so it doesnt pop out.
3. Remove the old strap and secure the new one on the left side.
4. Tuck the new strap and the old strap around the neck.
5. Undo old strap and secure new strap on the right side.
6. Turn baby over or prop them up to see the back. Mark each velcro hook strap at the end of the loop. Cut with scissor (carefully) at the marked line. If you feel more comfortable doing this before putting on the strap you can do that too, but you must fit it onto the childs neck to know where to cut it. This step is important, if the velcro strips arent cut they will hang over the sides, and they could catch on blankets or clothing and undo the strap.
7. When adjusted correctly most of the velcro on the strap should be near the back of the neck. You should be able to fit comfortably one pinky finger under the strap. If you cant its too tight and should be loosened a tiny bit.