Suctioning a Vented Trach

I have been kindly asked by Association of the Associations of Association of Trachs for Kids to create this blog about how to safely suction a trach set up on a ventilator. 

When someone feels something in their throat, they try coughing to get it out of their lungs. Someone who has a tracheostomy--an hole over the trachea--are not able to cough that foreign object out alone. Instead, a small tube is placed down the tracheostomy which acts like a vacuum to suction out the foreign objects, secretions, mucus, or saliva that is down there. 

What supplies are needed to suction a trach?

To safely and successfully suction out the foreign object, you will need the following:

  • Suctioning machine (Golisano Children’s Hospital, 2023)

  • Inline-suctioning device that’s the correct size for the patient (Golisano Children’s Hospital, 2023)

  • Sterile saline bullets to help thin the secretions (Golisano Children’s Hospital, 2023).


When do you know to suction a trach?

According to Dsouza et al, suctioning a patient should only occur when necessary (2021). How do you know it’s necessary? Listen to the person’s lungs. Do they should like they’re gurgling water, having a harder time to breathe, or their O2 levels are going down? These are all great indications the person needs to be suctioned.


What happens if I don’t suction?

If suctioning does not occur, those on a trach vent will begin to have fluid, such as secretions, mucus, and saliva, build up in their lungs. This can easily lead to hypoxia and pneumonia (Sinha, 2023). 


How do you safely suction a trach?

Below is a step by step process to safely suction someone with a trach:

  1. “Start by washing your hands” (Golisano Children’s Hospital, 2023).

  2. “Attach suction catheter to suction system. Make sure that suction is on and functioning properly and that the thumb valve is unlocked” (Golisano Children’s Hospital, 2023).

  3. “With one hand, hold the trach tube so it doesn’t move. Use the other hand to insert the catheter to the pre-measured depth” (Golisano Children’s Hospital, 2023).

  4. “Do not apply suction while inserting the catheter into the trach tube” (Golisano Children’s Hospital, 2023).

  5. “Apply suction by pushing down the thumb valve while you slowly remove the catheter. Be sure to hold on to the trach while removing the catheter. It’s important to hold on to the trach so it doesn’t accidentally get pulled out of place” (Golisano Children’s Hospital, 2023).

  6. “Do not suction for more than 10 seconds. Suctioning decreases the amount of oxygen (air) that your child is receiving as well as blocks the trach tube, making it difficult for the child to take a breath” (Golisano Children’s Hospital, 2023).

  7. “Wait at least 30 seconds between each time you suction to allow your child to rest and breathe” (Golisano Children’s Hospital, 2023).

  8. “Be sure to clean out the in-line suctioning device to remove secretions. To do this, attach a sterile saline bullet to the saline port then apply suction while squirting in the saline. Be sure to suction while instilling saline to prevent it from going down the trach” (Golisano Children’s Hospital, 2023).

Video on how to suction a Trach Vent:

https://www.youtube.com/watch?v=85eraWgiraw&themeRefresh=1



Source

Dsouza, R., Spillman, D. R., Barkalifa, R., Monroy, G. L., Chaney, E. J., Johnson, M. A., White, K. C., & Boppart, S. A. (2021, January).  Efficacy of endotracheal tube suctioning in intubated intensive care unit patients determined by in vivo catheter-based optical coherence tomography-A pilot study.  Quantitative imaging in medicine and surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719917/#:~:text=Traditionally%2C%20ETT%20suctioning%20is%20performed,only%20when%20necessary%20(14) 

Golisano Children's Hospital (2023).  Suctioning on a Vent.  Tracheostomy & Ventilator. https://www.urmc.rochester.edu/childrens-hospital/tracheostomy-ventilator-program/ventilator/suctioning-while-on-a-ventilator.aspx

Sinha,  V.,  Semien,  G.,  & Fitzgerald,  B.  M. (2023).  Surgical airway suctioning.  National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK448077/#:~:text=Suctioning%20can%20help%20maintain%20and,the%20mouth%2C%20or%20the%20nose


DISCLAIMER: this is not a real blog. This is an assignment for a class.(:

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