Suctioning

Suctioning

Definition
The purpose of suctioning the tracheostomy is to maintain a patent airway by removing secretions that the child is unable to cough out of the tracheostomy tube. It is the most frequently performed procedure on children with tracheostomies.

  • Equipment needed for suctioning
    • suction machine capable of running on a battery   
    • appropriate sized catheters
    • clean gloves
    • clean container to hold sterile water or saline
    • sterile water or saline to rinse suction catheter
    • manual resuscitation device and mask
  • How to suction
    • Sterile suctioning: single catheter use, sterile gloves
    • Clean suctioning: reuse catheter, clean gloves
    • Pre-measure catheter: suction only to end of tracheostomy tube
    • Applying suction: machine set at the correct pressure  
  • Assess secretions
    • Color
      • Normal color clear or white. 
      •  Yellow tinged in the morning.
      •  Yellow or green or brown) may indicate viral or bacterial infection.  
      • Blood tinged may be  from suctioning too deep, a granuloma,  pneumonia or a trach tube change.
    • Consistency
      • Ranges from thin to thick
      • Thicker secretions may be due to inadequate humidification, infection or dehydration.
    • Amount
      • Ranges from scant to copious.
      • Amount will increase with an infection.
    • Odor
      • Pseudomonas bacteria smells like dirty socks. 
      • An odor around the trach tube can be caused by the colonized bacteria.
  • Can cause significant complications.   
    •  Microatelectasis - collapse of the small alveoli.
    •  Hypoxia - lack of oxygen in the blood.
    • Granuloma - a mass or nodule of chronically inflamed tissue.
    • Bleeding from the trachea.
  • Know the details about the child such as reason for tracheostomy, size of tracheostomy tube and usual frequency of suctioning for the child.
  • Use of the approved suction techniques can prevent most complications.