Tracheostomy suctioning clears mucus and secretions from the airway of individuals with a tracheostomy tube. This tube, surgically placed in the windpipe, allows for breathing when the upper airway is obstructed. Suctioning maintains a clear airway, important for adequate ventilation and preventing serious blockages.
Many individuals with a tracheostomy tube cannot effectively clear their own secretions by coughing alone. This procedure helps remove accumulated mucus, ensuring the tracheostomy tube remains patent and respiratory health is maintained. While often performed by healthcare professionals, caregivers at home frequently undertake this task, making proper technique important for safety and effectiveness.
Essential Preparation
Before tracheostomy suctioning, preparation ensures a safe and effective procedure. Gather all required supplies: a functional suction machine, appropriately sized suction catheters, sterile gloves, sterile saline solution, a clean container, and gauze. A resuscitation bag should also be readily available for emergencies.
Hand hygiene is important before touching any equipment or the patient. Washing hands with soap and water or using an alcohol-based hand sanitizer prevents infection. Position the patient comfortably, in a semi-Fowler’s position or sitting upright, to optimize airway access and secretion removal. If conscious, explain the procedure to alleviate anxiety and promote cooperation.
Turn on the suction machine and check for proper function. For adults, suction pressure settings range from 80 to 120 mmHg. Maintaining sterility is important throughout preparation; ensure suction catheters remain in their sterile packaging until use and sterile gloves are donned correctly just before the procedure.
Step-by-Step Suctioning
Once preparations are complete, begin the suctioning procedure by donning sterile gloves to maintain an aseptic field. Remove the sterile suction catheter from its packaging, handling only the connector end to preserve sterility. Connect the catheter to the suction tubing, ensuring a secure fit.
With the suction machine active, gently insert the catheter into the tracheostomy tube without applying suction. Insert typically until slight resistance or a cough is met, then withdraw slightly (1/4 to 1/2 inch).
Apply intermittent suction by covering and uncovering the control port as the catheter is slowly withdrawn. Use a rotating motion while withdrawing to collect secretions from all sides of the airway. Each suction pass should be brief, lasting no more than 10 to 15 seconds to minimize oxygen depletion. Observe the patient for signs of distress.
Between passes, allow the patient to rest for 20 to 30 seconds to re-oxygenate. If secretions persist, perform additional passes, adhering to brief durations and rest periods. Clear the catheter between passes by suctioning sterile saline from a clean container. Once the airway is clear, dispose of the used catheter and gloves immediately.
Addressing Common Concerns
During tracheostomy suctioning, caregivers may encounter common reactions or issues. Patient coughing is often a frequent, normal, and helpful reflex. Coughing often dislodges secretions, making them easier to remove.
If the suction catheter meets resistance upon insertion, gently withdraw it slightly and reinsert at a different angle. Ensure appropriate catheter size. If secretions are not effectively coming up, check suction pressure settings and confirm proper catheter insertion and no kinks.
Minor blood streaks in secretions are common due to mild tracheal irritation and are usually not concerning unless bleeding is significant or persistent. Discomfort or anxiety is also common. Offer verbal reassurance and maintain a gentle technique to comfort the patient.
Post-Suctioning Care and Monitoring
After suctioning, carefully observe the patient for improved respiratory status. Monitor for easier breathing, improved skin color, and comfort, indicating a clear airway. Quieter breathing sounds also confirm successful secretion removal.
Clean reusable equipment (suction tubing, collection container) per specific healthcare provider instructions. This often involves rinsing with water and air drying to prevent bacterial growth. Documenting suctioning time, secretion amount/type, and observations can also aid ongoing care.
Seek immediate medical attention if the patient experiences:
Persistent difficulty breathing
Significant or continuous bleeding from the tracheostomy site
Signs of severe respiratory distress
Fever
New signs of infection at the stoma site (redness, swelling, pus)
Noticeable change in the color or odor of secretions
Chest pain
Any other new and concerning symptoms