STEPS IN ENDOTRACHEAL AND TRACHEOSTOMY TUBE SUCTIONING

1. Explain the procedure to the client

client.
2. Wash hands before and after and observe appropriate infection control procedures.
3. Provide privacy and place the client o
on semi-Fowlers position to promote deep breathing and maximum
lung expansion.
4. Attach the resuscitation apparatus to the oxygen so
source and adjust
st the oxygen flow to 100%.
5. Open the sterile supplies
pplies and place the sterile towel below the client’s tracheostomy.
6. Turn on the suction
ction machine and set the pressure in accordance to the hospital policy.
7. Put on sterile gloves and hold the catheter using a forceps on dominant hand and the connector on the non
dominant hand.
8. Flush and lubricate the catheter by placing the tip in saline solution.
9. Using the thumb of your non dominant hand, occlude the thumb control and suction small amount of
sterile solution through the catheter.
10. Hyperventilate the patient before and after suctioning.
11. Using your non dominant hand turn on the oxygen to 12- 15L/min, (disconnect
disconnect the oxygen source from the
tracheostomy tube if the client is receiving oxygen
oxygen).
12. Attach the resuscitator to the tracheostomy or endotracheal tube and compress the Ambu bag 3 - 5 times,
as the client inhales. (If the
he client is on ventilator, use it as hyperventilation and hyperoxygenation).
13. If the client has copious secretions, do not hyperventilate with a resuscitator, instead keep the regular
oxygen delivery device on and increase the flow rate or the FiO2 to 100% for several breaths before
suctioning.
14. Gently advance the catheter without applying any suction into the tracheostomy/endotracheal tube.
15. Insert the catheter about 12.5 cm for adults and less for children or until the clients cough
co or if there is
resistance.
16. Apply intermittent suctioning for 5 – 10 seconds by placing the non dominant hand on the suction port.
17. Withdraw the catheter completely and release the suction.
18. Flush the catheter by instilling normal saline solution into the irrigation port an
andd apply suction. Repeat
until the suction catheter is clear.
19. Reassess the client’s oxygenation
tion stat
status and repeat suctioning (allow 2-3
3 minutes between suctioning).
20. Flush the suction catheter and repeat suctioning until the passage is clear.
21. After each suction
ion hyperventilate the patient using your non dominant hand and ventilate the clients in no
more than three breaths.
22. Cleanse the suction tubing and disconnect the ttubing on the suction machine.
23. Provide client a comfortable, safe pos
position that facilitates breathing and lung expansion.
expansion
24. Record relevant data including the amount and the description of suction secretions and any other
relevant assessments.

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