Today our topic of discussion is Procedure of Tracheostomy Suctioning.
Procedure of Tracheostomy Suctioning
Procedure
- Open sterile towel and place in bib like fashion on patient’s chest
- Open sterile gloves and place on sterile field
- If the patient is attached to ventilator test to ensure that disconnection of ventilator may be with one hand.
- Fill the sterile container with sterile water
- Open the end of the pack containing the suction catheter and connect it to the tubing of the suction machine
- Don sterile gloves, designating dominant hand for aseptic technique.
- Other hand is used to disconnect the patient from ventilator (Fig. 29.22)
- Using the contaminated hand disconnect the patient from the ventilator CPAP device or other oxygen source
- Ventilate and oxygenate the patient with the resuscitator bag 5 to 6 times
- In the spontaneously breathing patient coordinate ventilation with patients own inspiratory effort .
- Slide the cover off the catheter and rinse it through with sterile water/saline to lubricate it
- Insert the catheter into the tracheostomy as for as possible without applying suction
- Apply suction and quickly rotate the catheter while it is being withdrawn
- Limit suction time 10 to 15 seconds.
- Discontinue if heart is observed rate decreases by 20 beats per minute or if cardiac ectopy
- Ventilate the patient between suction with 4-5 manual ventilation
- Sterile normal saline 2 to 3 ml. may be instilled into the airway followed by manual ventilation then suction
- Rinse catheter between suctioning.
- Procedure with sterile water/saline
- Continue procedure as necessary to a maximum of 4 suction passes
- Give the patient 6 to 8 ‘sigh’ breaths with the bag
- Return the patient to the ventilator or apply CPAP or other oxygen delivery device
- Suck oral secretions from the oropharynx above the artificial cuff
- Deliver trachesotomy care as required
- If patient is not an respiratory assistance apply filter or humidifier as indicated
- Check vital signs
- Leave the patient as comfortable as possible
- Clear and clean equipment
- Wash and dry hands
- Document the procedure including in appropriate nursing notes.