Tracheostomy Care/ Tracheostomy

Suctioning Procedure

Purpose
To ensure and maintain a patent airway and
help prevent infection

Equipment:

Sterile tracheostomy care tray with 2 tray

Sterile suction catheter
Trach dressing
Gauze sponges
Drape
Trach ties
Brush
Forceps
Pipe Cleaner
Gloves

Equipment

Cleaning solution
Normal Saline/Sterile water;
Suction apparatus
Sterile saline for instillation
Anesthesia bag for hyperventilation prior to and
after suctioning
Eye protection

Tracheostomy Care
1. Gather equipment; Sterile tracheostomy care
tray, normal saline, hydrogen peroxide, eye
protection, suction apparatus, and anesthesia
bag
2. Wash hands. Put on clean gloves and remove
dressing
3. Remove clean gloves and rewash hands. Loosen
caps on hydrogen peroxide and normal saline.

Tracheostomy Care
4. Open sterile tracheostomy care tray.
5. Don sterile Gloves
6. Remove drape with plastic liner from tray and
set up sterile field.
7. Arrange contents of tray onto sterile field.
8. Pour saline and cleansing solution into separate
containers.
9. Remove trach collar

Tracheostomy Care
10. Remove inner cannula and immerse in
cleansing solution. Clean inner cannula with
brush and pipe cleaners
11. Immerse and rinse inner cannula in sterile
saline or water
12. Replace inner cannula and resume oxygen
therapy if ordered.
13. Clean trach stoma site with cotton tipped
applicator and/or moistened with saline

Tracheostomy Care
14. Assess for evidence of wound erosion.
15. Use 4x4 with saline to clean trach plate and outer
cannula.
16. Apply dressing to trach site.
17. If twill tape ties are soiled, replaces ties
18. For new trach, change ties after 48 hours; Then
every 8 hours if needed; Progressing to every 24
hours if dry and clean
19. Discard equipment, wash hands, and document
procedure.

Tracheostomy Suctioning
1. Assess client for need for suctioning.
2. Wash hands
3. Gather equipment: Suction kit (includes
catheter, basin, gloves), Suction apparatus, eye
protection and sterile saline
4. Explain procedure. Apply eye protection. Test
suction apparatus.
5. Open suction kit. Don gloves

Tracheostomy Suctioning
6. Pour saline into container
7. Attach catheter to suction tubing
8. Wrap catheter in hand to maintain its sterility.
9. Lubricate tip of the catheter with saline
10. Have assistant instill 5cc sterile normal saline
into trach on inspiration.
11. Have assistant hyperoxygenate lungs prior to
suctioning

Tracheostomy Suctioning
12. Without applying suction, insert suction
catheter about 6 inches or until client coughs.
13. Upon stimulation of cough reflex, apply suction
intermittently and slowly rotate the catheter
between dominant thumb and forefinger as the
catheter is withdrawn (within 10 seconds).
14. Assess apical pulse and breath sounds.
15. Repeat steps 12 and 13 base on assessment:
Limit suctioning to 3 passes of catheter.

Tracheostomy Suctioning
16. Assistant should hyperoxygenate client as per
step 3 between each suctioning pass.
17. Discard equipment, Wash hands and
document procedure.