Tracheostomy

Suctioning Your Tracheostomy Tube

Suctioning is an important procedure to clear secretions (mucus) from the lungs or airways. If too many secretions are allowed to accumulate, the tube may become clogged and it will be difficult or impossible for the patient to breathe. Oftentimes, patients who are trached do not have an efficient cough to clear secretions. It may be performed as needed depending on the patient’s mucus production. Suctioning is considered a “sterile” procedure and should be performed with this in mind. It is not always possible to maintain sterility in the home, so we ask that you try to be as “clean” as possible when suctioning an airway.

It is important to gather all of your supplies in advance of suctioning or have them ready at all times in case the patient needs to be suctioned in a hurry. Supplies needed are a suction machine with an aspiration container in place (some patients put some betadine in the container to keep the suctioned contents camouflaged and neutralized), a suction catheter, saline or sterile water, the container for saline or water, sterile or clean gloves.

How to Perform Tracheotomy Suctioning?

• Turn on the suction machine and test the connecting tubing to make sure you are getting enough suction
• Prepare a container with saline or sterile water
• Get suction catheter out and peel back package halfway.
• Put on gloves, keep your dominant hand as your “clean/sterile” hand and your non-dominant hand as your “dirty” hand.
• Using your “clean” hand, remove the catheter from the package, being very careful NOT to let it touch anything or any surface.
• Slide the catheter down the patient’s trach opening (do not use the thumb port on the way down, the thumb port is to allow you to suction)
• Once the catheter reaches the carina (or where the lungs split off from the airway) the patient will usually cough or heave, do not go down any further.
• With your clean hand, put your thumb over the “thumb port” and intermittently move thumb off and on the port to allow you to suction the mucus as you slowly pull the catheter back out of the trach opening, using your “dirty” hand to help pull cath up. If you cover the thumb port for too long, the catheter may cause damage to the mucosa of the airway.
• If it is needed to go into the airway to suction again, be sure to pass saline or sterile water through the catheter to clear any secretions that may be stuck to the catheter or blocking it.
• Once done suctioning, using your “dirty” hand, roll the catheter up and dispose of it along with your gloves.
• Make sure to place the patient back onto oxygen if you have taken them off to suction

A note about Suction Catheters: they are ordered by your healthcare provider in a certain size (most common is size 14 fr or French). The number refers to the length of the catheter and “Fr or French” refers to the style of the catheter.

Notes: never try to reuse a suction catheter, always maintain as much sterility or cleanliness as possible when performing suctioning. If when suctioning, blood appears, be sure you have not let the cath stick to the mucus membranes of the airway and be sure to be gentle when passing the suction catheter down or up the airway. If you still see blood coming from the airway, this needs to be reported to your physician or healthcare provider.

At first, suctioning may be an awkward procedure, but as it is performed more and more frequently, you will become an expert at suctioning and will know exactly how far the catheter needs to go down the airway to get all of the secretions. As always, when in doubt, contact your MD or healthcare provider.