Tracheostomy Suctioning II: Procedure

Hyperventilating the patient using a manual resuscitation bag with 3 to 6 breaths before suctioning helps prevent hypoxemia, which occurs when oxygen levels drop during the procedure. This pre-oxygenation ensures the patient maintains adequate oxygen saturation throughout suctioning and reduces the risk of respiratory complications.

The dominant hand must remain sterile to handle the suction catheter directly, preventing contamination and infection. The non-dominant hand, which is clean, controls the suction valve by occluding the Y port. This separation of sterile and clean technique maintains aseptic conditions and protects the patient from introducing pathogens into the airway.

Each suctioning attempt should last only 10 to 15 seconds to minimize airway trauma and mucosal damage. The catheter is inserted gently and quickly into the trachea, rotated while withdrawing, and suction is applied intermittently by occluding the Y port with your thumb to regulate pressure and protect delicate airway tissues.

After suctioning, hyperventilate the patient again and replace the oxygen delivering system to restore oxygen delivery. Flush the catheter with sterile saline to clear secretions, assess breath sounds for improvement, and repeat suctioning up to three times if needed based on patient condition. Finally, dispose of equipment, ensure patient comfort, remove PPE, and perform hand hygiene.

Open the sterile suction package using aseptic technique to create a sterile field, then pour sterile saline into a sterile container. Put on sterile gloves, ensuring your dominant hand remains sterile for catheter handling. Moisten the catheter by dipping it in sterile saline and connect it to the suction tube before beginning the procedure.

Intermittent suction is applied by occluding the Y port on the catheter with your thumb on the non-dominant hand, allowing you to regulate suction pressure and prevent mucosal damage. This controlled technique reduces trauma to delicate airway tissues compared to continuous suction, while still effectively removing secretions to maintain airway patency.

Wear a gown, goggles or face shield, and a mask to protect against airborne secretions and splashing. Additionally, put on sterile gloves with the dominant hand remaining sterile to manipulate the catheter and the non-dominant hand clean to control the suction valve, maintaining proper aseptic technique throughout the procedure.