Tracheostomy Care and Suctioning

1. Read the patient’s chart.

 Name of the patient  Room No.

 Birth date  Date and Time
 Age  Attending physician
 Hospital No.  Physician’s order: "Trach care suctioning”

2. Prepare the needed equipments/supplies.

 Drape  Bandage scissors

 Suction catheter  Trach care kit:
 Clean and Sterile gloves - Hydrogen peroxide and saline solution
 Stethoscope - Gauze
 Pulse oximeter - Pipe cleaner
 Hemostat - Cotton tip applicator

3. Enter the patient's room and introduce yourself to the client.

- Use 2 identifiers (name and date of birth)
4. Perform hand washing
5. Wear PPE (such as gloves)
6. Auscultate the chest using stethoscope.
- Instruct the patient to take some deep breaths.
7. Check the oxygen saturation using pulse oximeter.

Suctioning

8. Grab the suction catheter from the wall and set the suction level to 100 to 120 (adults) or
80 to 100 (pediatrics)
9. Place the drape over the patient’s chest.
10. Set the sterile field
 Open the trach care kit.
 Put the sterile gloves.
 Place the drape out with the shiny side down.
 Grab the suction catheter.
 Separate the gauze (four by four and the drain sponges with the slit)
 Grab the trach ties.
 Grab the normal saline solution and hydrogen peroxide.
  Grab the pipe cleaner and cotton tip applicators.

11. Pour 50% of the saline solution into the large compartment and then the other 50% between
the other two compartments.
12. Pour 50% of hydrogen peroxide together with the 50% saline solution
13. Remove the inner cannula from the patient and put that in the 50-50% solution. Let it soak for a
bit.
- Keep one hand sterile and the other hand clean.
14. Grab the suction catheter and attach to the suction tube that is connected to the machine.
15. Prime the suction catheter with the normal saline.
16. Keep the controller open as you insert the catheter.
17. The nurse will feel a little bit of resistance.
18. Close the controller as you remove the catheter upwards in circular motion.
19. Dispose the catheter
20. Return the oxygen
21. Now, remove the inner cannula from the 50-50% solution and clean it with a pipe cleaner
- Make sure to hold the top part of the inner cannula using your clean hand
22. Rinse it in the other saline solution.
- Make sure to dry before reinsert
23. Reinsert the inner cannula
- Make sure it locks into place

24. Continue the trach care by changing the gauze.

25. Take the cotton tip applicator and put it in the saline solution.
26. Remove the gauze from his neck
27. Clean around the trach site and dry it with gauze.
28. Change the trach ties.
 Start where the knot is originally located and tie it on the opposite side
 Untie and remove the old ties.
29. Now, apply the clean gauze.
30. Remove the drape and reapply the oxygen.

Reassess the patient.

31. Auscultate the chest using stethoscope.

- Instruct the patient to take some deep breaths.
32. Check the oxygen saturation using pulse oximeter.
33. Clean up the area
34. Perform handwashing