03.03 Trach Suctioning

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In this video we're going to talk about suctioning a tracheostomy. You may need to do this before you do trach care or just because the patient requires suctioning. Make sure that you assess the patient before you start so that you know what their one sounds are, and what their oxygen saturation is.

Make sure your suction setup is working - you should have tubing attached to a canister, attached to a regulator. For this, you want to set it on continuous medium suction. You also want to make sure you can reach the end of the suction tubing - sometimes I lay it over the head of the bed or on the patient’s chest.

Now, usually I will loosen or unsnap the patient’s trach collar or oxygen source just to make sure I can easily move it with one hand - as long as you’re still able to deliver oxygen while you finish getting ready.

So, first, you’re going to open the sterile water and set the bottle on the table between you and the suction kit.
Now you can open your suction kit and put on your sterile gloves from in that kit. Sometimes they’re all bunched up and sometimes they have their own package, just be careful to keep them sterile.

Now you’ll open the little water container in the package and set it up on your sterile package.
Next you’re going to grab the suction catheter in your dominant hand. Put the catheter pointing downward in the palm of your hand and wrap it around your hand til you can grab the plastic suction control port.

Now at this point your non-dominant hand is going to go unsterile. Grab the water bottle and pour some in the container.
Then grab the suction tubing and push it onto the plastic suction control port without touching your other glove or the catheter.
Now you’re ready to suction. Use your non-dominant hand to move the oxygen source to the side.
With the same hand, grab the suction control port - this is the hand that is going to control the suction. When your thumb is over the port, suction is active.

Carefully unwrap and insert the suction catheter without suctioning. You’ll go in about 4 to 6 inches, or if the patient coughs, stop and pull it out 1 cm.

Then you’ll apply intermittent suction with your thumb while you gently pull out and twist the catheter in circles. This whole thing should take less than 10 seconds! Remember - you’re blocking their airway!

Once you’re out, hold the catheter away from the patient to keep it sterile and replace their oxygen source with your non-dominant hand while you decide whether they need another pass.

If the secretions were super thick, you can suction some of the sterile water through the catheter to clear it out.
You can do up to 3 passes with one catheter, no more than 10 seconds per pass. But if at any point the catheter becomes unsterile, you need to stop and get a new one before continuing!

When you’re done, be sure to re-attach the patient’s oxygen source. Then discard all of your supplies.
Of course, you’ll also want to reassess the patient to make sure the suctioning was successful. And you can move on to trach care now if you need to.

We hope that was helpful! Now, go out and be your best selves today. And, as always, happy nursing!
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