How to Suction a Tracheostomy

A tracheostomy, or trach, is a surgically created opening in the trachea. It is important to suction a trach from time to time. Doing this:

• Removes mucus and other fluids that build up in the trachea.
• Keeps the airway clear.
• Makes it easier to breathe.

Two people may be needed to suction a trach.

Supplies needed:

• A suction catheter.
• Clean gloves.
• Sterile gloves.
• A clean towel or paper drape.
• A suction machine.
• Connecting tubing.
• Sterile container.
• 0.9% saline solution or sterile water.

How to suction a trach

When you suction a trach, make sure to follow any specific instructions that were given by the person’s health care provider.

1. Have all supplies ready and available.
2. Wash your hands.
3. Put on clean gloves.
4. Attach one end of the connecting tubing to the suction machine. Place the other end next to the person who has a trach.
5. Turn on the suction machine.
6. Set the vacuum regulator to the appropriate negative pressure.
7. Have the person take deep breaths.
8. Prepare the suction catheter. While you do this, make sure the tube tip does not touch any non-sterile surface.
9. For a One-Time-Use Catheter:
   1. Open the catheter or kit.
   1. Lay a clean towel or paper drape across the person’s chest.
   1. Unwrap or open the sterile container and put it on a nearby table.
   1. Pour the saline solution or sterile water in the container.
   1. Take off your gloves.
   1. Wash your hands.
   1. Put on sterile gloves. After you put these gloves on, do not touch any non-sterile surfaces.
10. For a Closed-Suction Catheter:
    1. Take off your gloves.
    1. Wash your hands.
    1. Put on sterile gloves. After you put these gloves on, do not touch any non-sterile surfaces.
11. Pick up the connecting tubing and the catheter, and attach the connecting tubing to the catheter tubing.
12. To check that all equipment is working as it should, try suctioning a small amount of saline solution from the container.
13. Suction the trach. To do this:
    1. Give extra oxygen as needed.
    1. If the person is receiving mechanical ventilation, open the suction access (swivel adapter). If necessary, remove the oxygen or humidity delivery device.
    1. Without applying suction, gently and quickly insert the catheter into the trach using your thumb and forefinger. Try to do this at a time that you feel resistance or when the person coughs. As soon as you have inserted the catheter, pull it back ½ inch (1 cm).
    1. If the person is receiving mechanical ventilation, close the swivel adapter or replace the oxygen delivery device.
    1. Have the person take deep breaths.
    1. Rinse the catheter and the connecting tubing with saline solution or sterile water until it has been cleared. Use continuous suction.
    1. Repeat these steps one or two more times until the person no longer has noisy breathing. Pause for at least 1 minute before you repeat these steps.
    1. Suction secretions out of the mouth.
14. When suctioning is complete, disconnect the catheter from the connecting tubing.
15. Roll the catheter around your fingers.
16. Pull the glove off inside out so that catheter remains coiled in the glove. Pull off the other glove over the first glove in the same way.
17. Throw away your gloves.
18. Turn off the suction machine.
19. Remove the towel or paper drape.
20. Put on clean gloves.
21. Give extra oxygen as needed.
22. Throw away any used supplies.
23. Remove your gloves.
24. Wash your hands.