7.22 : Tracheostomy Suctioning II: Procedure

Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting the catheter, patient ventilation, suctioning, post-suction care, and completion of the procedure. Nursing students can ensure effective and safe tracheostomy suctioning by following these steps, improving patient outcomes.

Step 1: Sterile Field Preparation

Perform hand hygiene, then open the sterile suction package using an aseptic technique to create a sterile field. Pour sterile saline into a sterile container.

Step 2: Donning PPE

Wear a gown, goggles or a face shield and mask. Put on sterile gloves, ensuring the dominant hand remains sterile to manipulate the catheter and the non-dominant hand is clean to control the suction valve.

Step 3: Catheter Lubrication and Connection

Moisten the catheter by dipping it into the sterile saline container and connecting it to the suction tube.

Step 4: Patient Ventilation

Hyperventilate the patient using a manual resuscitation bag, delivering 3 to 6 breaths to aid in preventing hypoxemia during suctioning.

Step 5: Suctioning

Insert the catheter into the trachea gently and quickly. Apply suction by intermittently occluding the Y port on the catheter with your non-dominant hand to regulate suction pressure and prevent mucosal damage. Rotate the catheter as it's drawn. Avoid suctioning for longer than 10 to 15 seconds at a time.

Step 6: Post-Suction Care

After performing suctioning, proceed to hyperventilate the patient once more. Then, replace the oxygen delivery device and instruct the patient to take deep breaths. Following this, flush the catheter with saline solution, assess the effectiveness of the suctioning process by checking for improvement in breath sounds, and repeat up to three times, based on the patient's condition.

Step 7: Completion of Procedure

When suctioning is completed, dispose of used equipment correctly, assist the patient to a comfortable position, remove PPE, perform hand hygiene, and offer oral hygiene to the patient. Reassess the patient's status, including respiratory rate, effort, oxygen saturation, and lung sounds.