Nurses have a great deal of responsibility when it comes to suctioning patients with a tracheostomy. It is perhaps one of the biggest responsibilities that they have regarding airway management. The suctioning process should be done with a great deal of clinical skill and care to make patients comfortable.
What is a Tracheostomy and How to Determine if a Patient Needs Suctioning
A tracheostomy is a process that involves opening the airway of a patient. The goal of this process is to maintain an open airway, prevent infection, and prevent the destruction of the skin surrounding the opening. Nurses must ensure that everything remains sterile during the process to prevent potential infections.
A nurse knows when a patient needs tracheostomy suctioning when the patient is coughing, having difficulty breathing, gurgling, breathing quickly, or making bubbly sounds. The suctioning process should be done before the patients sleeps or eats for the best results. Vomiting may occur if nurses suction patients after eating.
Steps on How to Suction a Tracheostomy
- Gather all the necessary materials needed for the tracheostomy.
- Get acquainted with the patient so that he or she is comfortable before continuing.
- Wash the hands with soap and warm water. Make sure that the clean hands are completely dry before proceeding with the tracheostomy process.
- Carefully put on a pair of sterile gloves and begin the process.
- With a gloved hand, grab the catheter at the end that is connected to the suction machine.
- Allow the end that will attach to the trach tube to remain untouched for now.
- Before connecting the catheter, the nurse should know how far to insert the catheter before beginning suctioning. Nurses should add ¼ inch to the length of the trach tube to determine how far to insert the catheter.
- Holding the catheter at the suction depth, attach the suction machine tubing and the catheter and turn on the machine.
- Do not apply any pressure while placing the catheter inside the trach tube. The catheter should follow the trach tube’s curve. Do not force the catheter and stop at the predetermined measurement.
- A trach tube that does not pass the catheter may have a blockage inside it so it may be necessary to add saline and resume the process. If the process fails a second time, it may be necessary to change the tube and start the process again.
- Use the forefinger and the thumb to pull out the catheter. While retracting the catheter, use the thumb to apply a light amount of pressure to the whole in the catheter.
Video on How to Suction a Patient with a Tracheostomy
Tips on Tracheostomy Suctioning
- Always wear gloves when suctioning so that germs and infections are not transferred.
- Never suction for lengths of time longer than 5 or 10 seconds.
- Use saline solution in the trach to loosen secretions and make the suction process easier.
- Wash hands before and after suctioning a patient—even if gloves are worn.
- Do not use saline solution during the first suction in order to determine how the secretion looks before suctioning.
- It is recommended that nurses give patients air before and after suctions using a bag to provide oxygen to the patent’s lungs.
- Look for thin or slightly thick white or clear secretion as normal secretion for patients.
- Suction several times if the patient’s secretion is very thick. Apply saline solution if needed.
- Allow a minimum of 30 seconds between suctions to allow the patient time to rest.
- Adding saline solution to the trach may cause the patient to chock or cough but will help loosen secretion in patients.
Complications with Tracheostomy Suctioning
There are not many complications that can come from tracheostomy suctioning because the process is relatively benign. The most serious risk of suctioning is unintentional removal of the tube. In this situation, the airway can be lost. Another complication is blocked oxygen. When nurses suction patients too long, it prevents any oxygen from entering the patient’s lungs.
The tracheostomy suctioning process may seem extremely easy, but it requires a great deal of skill and precision in order to execute. Patients depend of the skills of nurses to open their airways and assist with helping them to breath. The process can be very pleasant for patients if the nurse administering the suctioning uses care in his or her work. The suctioning process should be practiced many times in order to gain the skills to perform a tracheostomy suctioning quickly and efficiently so that patients experience no discomfort or pain. Once nurses understand the steps involved in tracheostomy suctioning, they will become an asset to any hospital staff.