(3) Watch closely for bleeding from the incision, and look for blood in the
aspirated secretions when suctioning.
(4) Be alert for choking or coughing when the patient swallows. This may
indicate damage to the esophagus with leakage of swallowed material into the trachea.
2-39. PERFORMING TRACHEOSTOMY SUCTIONING
a. Assemble the necessary equipment.
Portable continuous suction machine or in-wall suction.
(2) Sterile suction kit containing sterile suction catheters (14-18Fr.), a
sterile solution container, and sterile gloves.
Sterile saline in a pour bottle.
Sterile gauze sponges.
Sterile normal saline in 5cc packets for tracheal instillation, if ordered.
Oxygen source with flow meter and a manual resuscitator (ambu bag).
b. Explain the suctioning procedure to the patient if he is conscious.
(1) Hyper oxygenation will be performed. An ambu bag with 100 percent
oxygen will be connected to the tracheostomy tube and the patient will be given several
breaths prior to suctioning. This is done to prevent shortness of breath or hypoxia.
(2) Approximately 5cc of normal saline will be instilled into the tracheostomy
tube to help liquify secretions. Inform the patient that this may stimulate a cough reflex.
c. Place the patient in semi-Fowler's position if permitted.
d. Wash your hands and set up the sterile suction kit.
(1) Open the suction kit, using the wrapper to create a sterile field. Place
the sterile sponges on the field.
Pour 50-100cc of sterile saline into the solution container, using a septic
e. Turn on the suction unit and set to low pressure to avoid trauma to the