Tracheostomy suctioning is a procedure that helps clear mucus secretions in people with a tracheostomy tube. Some individuals may require frequent suctioning, for example, if they have a lung condition.

Adults typically know how to suction their own tracheotomies or have a caregiver who can. However, it may require two trained adults to perform this procedure for a child with a tracheostomy. This procedure can help in some cases where coughing alone is not enough to clear the airways. Generally, tracheostomy suctioning is safe. Regular suctioning can benefit overall tracheostomy care and help with airway management.

A trained healthcare professional can best advise on the type and frequency of suctioning someone requires. Usually, doctors can determine this information on an individual basis.

This article discusses more about tracheostomy suctioning, the steps, and indications for the procedure.

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Tracheostomy suctioning helps clear mucus and secretions around the tracheal opening and lower airway.

A person with a tracheostomy tube typically expels some of the secretions by coughing. However, secretions may accumulate in some cases and require suctioning. Without tracheostomy suctioning, mucus and other secretions can build up and cause breathing difficulties.

The frequency of tracheostomy suctioning varies for each person and depends on the circumstances. For instance, someone with a new tracheostomy or a medical condition that causes excess mucus secretion may require frequent suctioning.

While people with newer tracheostomies may require regular suctioning, the need declines as the body adapts. Additionally, tracheostomy suctioning is generally more frequent in people who cannot cough properly to expel the secretions.

Doctors typically assess individuals with a tracheostomy for signs of airway blockage, such as noisy or labored breathing. These signs generally suggest a possible need for tracheostomy suctioning. The healthcare professional in charge of a person’s care can advise when someone needs suctioning and how often.

Does suctioning hurt?

Tracheostomy suctioning should not be painful, but the person may experience varying degrees of discomfort. Gentle suctioning, which does not go too deep into the airway, could help reduce the level of discomfort a person might experience.

Medical experts recommend ceasing suctioning if someone notices any significant distress during the procedure.

A trained and experienced carer or caregiver can perform tracheostomy suctioning.

Generally, the following set of equipment is necessary for the procedure:

  • a suction machine with its connecting tubes
  • clean and sterile personal protective equipment such as gloves, masks, and goggles
  • sterile saline
  • a sterile suction catheter

After suctioning, it is essential to keep this equipment clean and safe.

Educating a person about tracheostomy suctioning and possible risks is an essential preparatory step.

The steps for tracheostomy suctioning at home typically include:

  1. The person performing the procedure needs to ensure they have washed their hands properly and are wearing gloves.
  2. Attach the suctioning tube to the connecting tube of the suctioning machine. Turn the machine on.
  3. Ensure the person receiving the suctioning has their head and shoulders elevated slightly. Coughing before the procedure and wiping away the mucus is beneficial.
  4. The individual receiving the suctioning should take three to four deep breaths before inserting the catheter.
  5. Gently insert the suction tube about 4–5 inches into the inner tube of the airway. They should apply no suction at this point.
  6. Once the catheter is in place or resistance is felt, apply suction by using the thumb to cover the suctioning vent (hole) of the tube.
  7. At the same time as applying the suction, gently start pulling out the catheter. Do not leave the suctioning catheter for more than 10 seconds.
  8. After suctioning, allow at least 10–15 seconds and allow the person to take deep breaths or to use oxygen if necessary. Rinse the catheter by suctioning saline or clean water in a separate bowl.
  9. Repeat steps 5–8 if necessary.

The carer needs to follow standard precautions and use clean suctioning equipment to reduce the risk of infection or contamination.

A person needs to carry out deep suctioning gently and carefully to reduce the risk of direct mucosal trauma or injury. They can perform the procedure frequently.

The suction catheter, connection tube, and suction machine require cleaning after use.

In addition to following the manufacturer’s directions, here are some steps in cleaning a reusable suction catheter:

  • Use clean tap water to rinse the suction catheter after use.
  • Store the catheter in a clean, sealed pack.
  • Use a lint-free cloth to dry the outside of the catheter.
  • Discard contaminated or cracked suction catheters.

When cleaning the suction machine, a person needs to empty the contents and use a plain dish detergent with hot water to clean the container. After this, they can dry it with a clean cloth.

Additional cleaning may be useful in some cases or as the manufacturer recommends.

Possible complications of tracheostomy suctioning include:

  • reduced blood oxygen concentration
  • mucosal trauma
  • bleeding
  • airway infection

Tracheostomy suctioning is generally a safe procedure. However, some complications may require intervention from a trained healthcare professional. For example, a sizeable mucus plug obstructing the trachea could be life threatening and requires urgent medical intervention.

Tracheostomy suctioning is a procedure that helps remove mucus and other airway secretions around the tracheostomy opening and lower airway. The procedure clears the airway and prevents difficulty in breathing.

People may frequently undergo tracheostomy suctioning if they produce excess secretions, after a new tracheostomy, or if they have a pulmonary or neurological condition. It should not be painful, but the person could experience varying degrees of discomfort.

There are standard precautions that a person or carer can follow before and during the procedure, all of which aim to reduce the risk of complications such as infections.