Tracheostomy Care
 Endotracheal and Tracheostomy
Suctioning
Endotracheal/Tracheal Suctioning
Procedure
 Endotracheal and tracheal suctioning
removes thick mucus and secretions
from the trachea and lower airway
that you are not able to clear by
coughing.
Endotracheal/Tracheal Suctioning
Procedure
1. Step 1: Gather the following
equipment and supplies: Sterile
Normal Saline, Suction Machine,
Ambubag connected to 100% O2,
Clear protective googles, Sterile
gloves for open suction, Clean
gloves for closed suction, Sterile
catheter with intermittent suction
control port
2. Step 2: Position the patient
comfortably with his or her head and
neck well-supported.
 Wash Hands.
3. Step 3: Fill the small paper cup or
glass about half-way with Normal
Saline. Place the clean glove on your
dominant hand If the patient has a
cuffed tracheostomy tube, check to
see if the cuff is properly inflated.
4. Step 4: Open the suction catheter
package. Pick up the hard plastic end
of the catheter with your gloved hand
and attach it to the connecting
tubing.
5. Step 5: Wrap the catheter around
your gloved hand when not in use to
avoid contamination of the catheter.
Turn on the suction machine with
your ungloved hand. Expose the
patient's tracheostomy opening.
6. Step 6: With your finger off the
suction vent, gently insert the suction
catheter into the tracheostomy
opening. Slowly advance the catheter
a maximum of 6 inches or until you
feels resistance. Cover the suction
vent with the thumb of your gloved
hand to apply suction. Withdraw the
catheter and rotate, using a slow and
even motion. Roll the catheter
between the thumb and forefinger of
your gloved hand. Apply suction as
you withdraw the catheter. Do not
apply suction for longer than 10
seconds. According to Ma’am Lim:
5x is the maximum repetition of
suctioning per session
 7. Step 7: Clean the catheter and  A curved tracheostomy tube is
connecting tubing between each inserted to extend through the stoma
suction pass; dip the catheter into the into the trachea. For clients who
small paper cup or glass, place your need long-term airway support.
finger over the suction vent and draw
up small amounts of Normal Saline
TRACHAESTOMY TUBE
through the catheter. Empty the
contents of the catheter into the
collection basin.
8. Step 8: Allow the patient 20 to 30
seconds to rest between suction
passes. When the patient's airway is
clear and you are finished suctioning,
fill a clean basin with Normal Saline.
Thoroughly flush the NSS through Providing Tracheostomy Care

the catheter and connecting tubing. Purposes:

9. Step 9: Turn off the suction  To maintain airway patency

machine. Slide the catheter back into
the package and disconnect it from
the connecting tubing. Hang the
connecting tubing on the suction
machine with the tip pointing up.
10. Step 10: Take off your glove and
discard it properly. Wash your hands
with soap and water and dry with a
clean towel.
TRACHEOSTOMY
 A surgical incision in the trachea just
below the larynx.
 To maintain cleanliness and prevent
infection at the tracheostomy site
 To facilitate healing and prevent skin
excoriation around tracheostomy
incision
 To promote comfort
NOTE: Initially a tracheostomy may need
to be suctioned as often as every 1 –2
hours. After the initial inflammatory
response subsides, it may done once or
twice a day.
Equipment  Assist the client to a semi-Fowler’s
or Fowlers position.
1. Sterile disposable tracheostomy
cleaning kit  Prepare the equipment, open the
2. Towel tracheostomy kit. Pour hydrogen
3. Sterile suction kit peroxide into separate container
4. Hydrogen peroxide and sterile
normal saline  Establish a sterile field, open other

5. Sterile gloves sterile supplies: tracheostomy

6. Clean gloves dressing, suction

7. Sterile 4 x 4 gauze dressing

8. Cotton twill Suction the tracheostomy tube.

9. Clean scissors
 After suctioning, wrap the catheter
around your hand and peel the glove
Assessment:
off with the catheter inside the glove
 Respiratory status
and discard Hydrogen peroxide
 Pulse rate
moisten and loosens dried secretions
 Character and amount of secretions  Using the other gloved hand, unlock
from tracheostomy site the inner cannula (if present) and

 Presence of drainage remove it gently and place on the

hydrogen peroxide solution
 Appearance of incision
 Remove the soiled tracheostomy
dressing, place the soiled dressing in
Steps / Procedure your gloved hand and peel the glove
 Identify and inform the client and off with the soiled dressing and
explain the procedure. discard
 Put on another sterile glove. Keep
 Wash hands and observe other
dominant hand sterile during the
appropriate infection control
procedure.
procedure.
  Clean the inner cannula:  Handle the sterile supplies with

Remove the inner cannula from your dominant hand.

the soaking solution  Use each applicator or gauze

 Clean the lumen and entire cannula dressing only once and then

thoroughly using a brush or pipe discard

cleaners moistened with sterile NSS  Hydrogen peroxide may be used

 Rinse the inner cannula thoroughly to remove crusty secretions.

in the sterile normal saline  Thoroughly rinse the cleaned

 Using sterile technique, suction the area, using gauze squares

outer cannula. moistened with sterile normal

saline.
 Rinsing is important to remove
hydrogen peroxide  Clean the flange of the tube in
the same manner.
 Thoroughly dry the client’s skin
Replace the inner cannula, securing it in
and tube flanges with dry gauze
place:
squares. Insert the inner cannula
 Insert the inner cannula by
by grasping the outer flange and
grasping the outer flange and
inserting the cannula in the
inserting the cannula in the
direction of its curvature.
direction of its curvature.
 Lock the cannula in place by
 Lock the cannula in place by
turning the lock (if present) into
turning the lock (if present) into
position to secure the flange of
position to secure the flange of
the inner cannula to the outer
the inner cannula to the outer
cannula.
cannula.
 Clean the incision site and tube
flange:
 Using sterile applicators or gauze
dressings moistened with normal
saline, clean the incision site.