TRACHEOSTOMY SUCTIONING PROCEDURE

PURPOSE: To aspirate retained or excessive secretions for maintaining an open airway and aid the respiratory effort of the student. ACTION TO BE PERFORMED: By a licensed registered nurse whose training and scope of practice includes suctioning of a tracheostomy. ACTION 1. Wash hands (if time allows).
2. Position student in an upright position. 1.

POINTS OF EMPHASIS
Use approved hand washing technique; use gloves for protection against body fluids. Facilitates deep breathing and cough and allows for increased lung expansion. Provides emotional support to student to decrease anxiety associated with procedure. Potential for infection related to invasive procedure.

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Assemble equipment and open packages maintaining sterility of catheter. Put on protective equipment (gown, mask, & gloves). Open individual saline dosette for installation into trach tube. Fill container with sterile water for rinsing of catheter. Turn suction machine on. Leaving vent hole on suction catheter open (do not create suction while inserting) insert catheter gently into trach tube to pre-measured length.

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Protects against body fluids and potential for infection related to invasive procedure. For ease of insertion into each tube.

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To maintain infection control. Using non-dominant hand only. NEVER cover the vent while introducing the catheter. If catheter is inserted too deeply it can cause irritation/injury to the trachea, as well as bronchospasm. This rotating motion prevents the catheter from pulling tissue against it and causing injury. Prolonged suctioning blocks the student's airway and can cause a dangerous drop in the oxygen level.

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Cover vent hole on suction catheter with thumb and withdraw catheter from trachea with a steady rotating motion. (Hint: count one and two and two and three. Catheter should be out by three).

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10. Observe secretions for color, amount, consistency, and odor of secretions.

10. Normal mucous color is clear to cloudy white. A yellow or green color may indicate infection and should be reported to the parent. Encourage parent/guardian to inform health care provider. 11. Prevents hypoxia and helps to alleviate student's anxiety. 12. Breathing pattern is effective; thus breathing occurs easily and seems adequate for student. Student appears more calm and relaxed. 13. Facilitates clear tubing for future suctioning and ensures good infection control practice. 14. Ensures good infection control practice. 15. Ensures good infection control practice. 16. Dispose of properly and quickly.

11. Allow student to rest and return to normal breathing.

12. Repeat suctioning procedure as above if necessary.

13. When finished, suction enough sterile water through the catheter to clear the tubing of secretions. 14. Turn off suction machine. 15. Discard disposable equipment appropriately. 16. Remove gloves and protective equipment and wash hands. 17. Document procedure and results.

17. Chart date, time, rationale for procedure, amount and description of secretions, and student's response.