Tracheostomy Suctioning

Identify client and the need for suctioning/trach care

Assess need for pain medication prior to procedure

Inform the client of procedure

Obtain necessary equipment for both suctioning and trach care

Perform hand hygiene

Adjust the bed to a comfortable working position with client in a semi fowler's position. Place water proof pad or towel across client's chest for protection

Assess suction pressure. Need to be 100-150 mm Hg

Open sterile suction package using aseptic technique

Don face shield first, then carefully remove the sterile container, touching the outside surface only. Fill with sterile NS and apply gloves. Dominant hand will be sterile while non-dominant hand will be non-sterile

With your dominant, sterile gloved hand, pick up the sterile catheter. Using your non-dominant hand, pick up the tubing and connect it with your sterile suction catheter wrapping the sterile catheter around your sterile hand.

Remove client's oxygen/humidification source with non-dominant hand. Maintain a watchful eye on your client's oxygen saturation during procedure

Moisten tip of catheter by dipping into sterile saline and occlude the port. Sterile catheter will be in dominant/sterile hand

Gently and quickly insert the catheter into tracheostomy advancing gently taking care not to occlude the port while advancing until client coughs vigorously or you meet resistance.

Apply suction by intermittently occluding the suction port of your catheter with the thumb of your non-dominant hand. Gently rotate the catheter as it is being withdrawn. Never suction more than 10 seconds at a time (15 seconds is absolute maximum). HOLD BREATH

Replace client's oxygen source

Flush catheter with sterile NS from the sterile container. Wrap suction catheter around hand and allow client to rest for 30 seconds between suction passes. No more than 3 suction passes per any given suctioning episode

Remove excess secretions from catheter (wipe using towel or protective pad thus rendering your catheter non-sterile) and suction the oropharnyx. Remember, it cannot be reinserted into the trachea. Perform oral care.

Dipose of catheter by removing gloves and housing catheter inside of glove. Dispose of in the appropriate container.

perform hand hygiene

Prepare for tracheostomy care