Tracheostomy suctioning keeps the airway clear of mucus and other secretions. This procedure needs to be preformed several times a day by someone who’s trained to do it.
A tracheostomy is a surgical procedure that makes an opening in your trachea, or windpipe. A tube is placed into the opening, allowing you to breathe. You might have a tracheostomy if you have trouble breathing due to muscle weakness, cancer, an airway blockage, or if you need to use a mechanical ventilator.
The opening in your airway is sometimes called a stoma.
A tracheostomy may be temporary or permanent. A doctor may create one in an emergency or as a planned procedure in a hospital. Cleaning and suctioning the tracheostomy is an important part of in-hospital and home care.
Mucus and other secretions can build up in the area around the stoma. Coughing can sometimes get rid of this buildup, but coughing isn’t possible or sufficient for everyone. Suctioning is needed to keep the tracheostomy tube clear.
You may have to suction a tracheostomy more often when it’s new. The tube may need clearing several times a day, but this may decrease over time. You may also have times when you suction the tube more often, like when changes in your health cause more secretions in the area.
Some signs it might be time to suction the tube include:
- wet or noisy breathing
- increased effort to breathe
- use of muscles around your rib cage to breathe
- longer sounds when you exhale
- feeling like you aren’t getting enough air
- feeling restless
- coughing more or feeling like coughing isn’t clearing your airway
Regular tracheostomy suctioning can prevent the tube from plugging up completely.
Whether in the hospital or at home, only a trained person should perform tracheostomy suctioning. You can suction your own tracheostomy once you’ve learned how to do so safely and effectively. A hospital or home care nurse may be able to give you this guidance before or after discharge.
There are two types of suctioning: open and closed. Open suctioning involves using a single-use catheter to suction the airways. A person on a ventilator needs to be disconnected during open suctioning.
Closed suctioning allows the same catheter to be reused multiple times. For someone on a ventilator, closed suctioning also allows the ventilator line to stay in place.
Specific steps to suction a tracheostomy depend on the kind you have. In general, you or a healthcare professional may
- Preoxygenate to increase the amount of oxygen in your system. This may include taking deep breaths if possible.
- Remove the inner tube from the tracheostomy.
- Insert the suction tube no deeper than the inner tip of the airway.
- Suction for no more than 15 seconds and at a pressure no higher than 200 mmHg. Some sources recommend between 120 and 140 mmHg, and caution that pressure should be no higher than needed to remove mucus.
- Remove the suction tube.
- If suctioning is repeated, wait at least 10 to 15 seconds before suctioning again.
- Repeat no more than three times (suctioning four times total in one session) to prevent oxygen depletion.
Caring for a Tracheostomy
You can care for your tracheostomy with a few basic steps.
- Try to keep the tracheostomy in place with surgical dressing and tape. After a while, the opening in your windpipe may heal so that the dressing and tape are no longer necessary.
- Suction the tracheostomy to keep the airway clear.
- Clean the inner cannula (lining) or replace it as necessary to prevent blockage.
- Cover the tube with gauze while showering to prevent water from getting in.
- Let your healthcare team know if the skin around the tracheostomy is red or swollen, as this may be a sign of infection.
Suctioning a tracheostomy is usually safe if all precautions are followed. Some risks that come with airway suctioning include:
- trauma to the airway from too much pressure or placing the suction tube too deep
- not getting enough oxygen during the procedure
In a clinical setting, where a person gets an airway suctioning in a hospital, other complications may arise, but are very rare. These can include:
A tracheostomy is a surgical procedure to help someone breathe better. The tracheostomy needs to be kept clean and free of mucus and secretions.
Regular suctioning can help remove substances that can build up over time. Using minimal suction pressure, not going too deep into the airway, and preoxygenating before suction can all help prevent complications.