1. Be sure to have the cannula capped GOOD when taking a bath or shower.
2. If using a Jackson cannula or one of its variants, try to avoid having a lot of water running down onto the cannula. These cannulas are not airtight nor watertight, even when plugged.
3. Unless the cannula has a good airtight seal (not possible with Jackson cannulas), do not get the stoma (hole in your neck) and cannula submerged under water. Even if you do have a good airtight seal, avoid going more than a few feet under water due to increasing pressure.
4. NEVER work with chemicals that give off fumes until the cannula is plugged. When the cannula is open, your normal airway defense mechanisms are defeated.
5. Get to know your cannula well, so that you can deal with emergencies and such on your own (HOPEFULLY).
6. Never put objects into the cannula or stoma (hole in your neck) except that which is necessary for trach care (usually swabs dipped in saline solution or a 50:50 mixture of saline solution and hydrogen peroxide). This is more of an issue with children.
7. Always wash your hands before doing trach care.
8. Keep the manual(s) for the cannula in a safe place where you will remember it in the event of an emergency.
9. Try to minimize swab contact with the back of the trachea, for this may irritate it.
10. Do NOT push debris further into a cannula. If you are using a Jackson cannula, you can force the inner cannula in and forcefully blow out through it when you get past and knock some gook loose from the outer cannula.
11. If using a suction device, avoid excessive use of it. Also avoid excessive vacuum levels. For young children, a setting of about 50-100 mmHg should be used. For adults and older children, a setting of around 100-120 mmHg should be used.
12. Be sure to uncork your cannula before going to bed, lest you defeat the purpose of your tracheostomy (if you had obstructive sleep apnea). If using a Jackson cannula, be sure to use your inner cannula, for this is MUCH easier to clean than the outer cannula.
13. Avoid exposure to cold and/or rainy weather when the cannula is open. In fact, you should leave your cannula plugged as much as feasible during waking hours, particularly if going outside, even in the Summer. You don’t want a darn bee or some other critter making a home in your trachea!
14. When going to bed, make sure that you wear a shirt that leaves the cannula exposed. Wearing no shirt at all is fine. Even though normal shirts are not airtight, the cross-sectional area of the cannula is so small that when even a regular shirt is against it, it is almost like covering the cannula with plastic! This is more of a problem when inhaling, for the shirt will most likely get sucked up against the cannula.
15. 
16. When using shirts that do not expose the cannula (for daytime use only), be SURE that the shirt does not have a tendency to catch on the cannula, lest it may pull it out!
17. Unless you are using a Montgomery cannula (or one of its variants) and have had it for at least 6 months or so, avoid the use of shirt ties. If you MUST wear a tie, have it looser than normal. Wearing a shirt tie over a cannula whose stoma (hole in your neck) is less than 6 months old may cause substantial discomfort.
18. If you occlude your cannula frequently with your finger, be sure to wash your hands often.
19. If you are using a Jackson cannula (or one of its variants), do NOT stick swabs in there that have wooden sticks, for these tend to break. You don’t want a swab to break off in your cannula and not be able to get to it!
20. Do not go more than about a half hour without having a cannula in your stoma (hole in your neck). Going too long without a cannula in the stoma can cause a setback and possibly necessitate the need for another surgery! If you need to soak a cannula for several hours (to loosen up stubborn debris), insert a backup cannula into the stoma. This backup cannula should be the same diameter as the one that you just removed.  If your tracheostomy is less than 5-6 months old, try not to go more than 5-15 minutes without a cannula in place.
21. The inside of the cannula should be cleaned on a daily basis in order to help prevent stubborn mucous plugs from forming. They are easier to get out when they’re "young!"
22. Never touch the cannula or the area around it unless you have washed your hands first.
23. You should perform at least one patency test on your cannula before going to bed. You want to be sure that your cannula is gonna work "in the hour of need!"
24. Please review all emergency procedures, so you’ll know what to do, especially if breathing would get hindered.
25. If you need to wear a dust mask or respirator mask for certain types of work, be SURE to have your cannula plugged. If your cannula is open, it will be worse than not wearing a mask at all!
26. If you are having a bowel movement or even just having to pass gas, it is advisable to have your cannula plugged. While these particles and such in the air are usually harmless to most people, having an open cannula defeats your normal airway defense mechanisms and allows this junk to make a direct beeline to your trachea—and thus, possibly cause an infection.
27. As for sleeping area, the temperature should be comfortable, but free of drafts. The worst possible combination is having lots drafts and low humidity. This can cause lots of coughing during the night and impair your sleep quality.
28. If your sleeping area is cool and has a draft, you may be tempted to pull a sheet up over your head. This may or may not impair your sleep quality due to the reduction of good air exchange. However, do NOT pull heavy blankets or quilts over your head, for these can cause worse problems and might even cause you to have a headache when you wake up. A better alternative may be to rearrange your sleeping area or even move into another room. Please note that while a room may not be suitable in the Winter, may be fine in the Summer or vice versa.
29. As painful as it may be, you will need to avoid sports where you may get hit with a ball, along with boxing and wrestling. For God’s sake, you don’t want to have a ball or fist knock your cannula all the way into the stoma! However, you can still enjoy sports such as bowling, golf, hunting, fishing, running, and even gymnastics. You can also still engage in physical exercise. The only problems that you may have is an increased shortness of breath and/or increased airway resistance; These are normal when you have a cannula in your trachea. HOWEVER, if the shortness of breath is severe, slow down and allow your system to "catch up," particularly if you are much over the age of 30.
30. You should plug your cannula when you are mowing grass. You don’t want grass particles to end up in your trachea, particularly if a bird crapped on it lately!
31. If you need to use an inhaler, it is a good idea to either plug the cannula or occlude with your finger so that you can get the full dose of the medicine inhaled.
32. If working in a dusty environment or when doing woodworking, be sure to have your cannula plugged. You don’t want sawdust and other junk getting into your trachea!
33. Be sure to have the cannula capped when using aerosol sprays, powders, or any other substance that can leave loose particles and/or droplets in the air.   Even toilet paper and many kinds of tissues can leave particles floating around in the air.
34. Do NOT use any lotions or ointments around the stoma unless directed by your doctor.  If you have a lot of redness and/or rawness partly around the stoma, you may wish to use some Bacitracin Zinc ointment.  However, if you do use this, do NOT get within about ¼” of the stoma, or you’ll be encouraging growth of granulation tissue, which is kind of bad news.
35. If the skin around the stoma is raw, do NOT use hydrogen peroxide or a strong saline solution, or you’ll just aggravate the problem.
36. You may wish to mix up some saline solution and hydrogen peroxide in a small plastic bottle or jar for easy use. Just make sure that you don’t contaminate it by coughing into it or sticking used or soiled instruments and such into it. Please note that the mixture does not have to be exact and can be visually estimated. Below is a picture of a plastic specimen jar that is absolutely ideal! For God’s sake, don’t use one that has been peed in or something!

To summarize things, make sure that your cannula is plugged in the following situations:
 

- Cold, windy, or rainy weather
- Presence of flying insects
- When taking a bath or shower
- When wearing a mask or respirator to filter out dust and/or fumes
- When working around volatile chemicals and those with fumes
- When mowing grass
- When working in dusty areas or doing woodworking
- When using sprays, powders, or any other substances that can leave particles and/or droplets in the air

While I tried hard to cover all the bases when it comes to avoiding problems with your tracheostomy, I cannot guarantee that you will not have problems. I will not be liable for any omissions or errors in this document.