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Suctioning a Tracheostomy

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Suctioning your child:

The purpose of tracheostomy suctioning is to remove mucus from your child's trach. You may feel afraid when you first start doing the suctioning. This is normal. Try to remember, you are not hurting your child, you are helping him/her to breathe. Each time it will become easier for you to do.

When to suction:

Suction your child as needed. You can see, feel, and hear signs that your child needs to be suctioned. What you will see and hear most commonly:

  • Your child may have trouble breathing.
  • He/she may breathe faster.
  • There may be bubbles of mucus at the trach opening.
  • You may feel a "rattling" when you touch your child's chest and back with the flat part of your hand.
  • You may also hear a “rattling” in your child’s chest.

Other symptoms your child may have:

  • Your child may become restless and cannot be calmed by cuddling or rocking.
  • The hollow in his/her neck may "pull in".
  • The area below the breastbone may "pull in".
  • He/she may have a "frightened look" on his/her face.
  • An infant may have difficulty sucking or eating.
  • The color around his/her mouth may look pale, bluish, or dusky.
  • His/her nostrils may flare out.

If you see any of these signs, suction out the mucus.

Equipment needed for suctioning:

  • Portable or stationary suction pump
  • Connecting tubes
  • Suction catheter size __________
  • Saline/saline bullets – This may come from an equipment company or a pharmacy.

To suction:

  1. Wash your hands.
  2. Pull back sleeve from catheter. Do not touch tip of the catheter with your fingers or anything else.
  3. Dip the tip of the catheter into the cup of saline to moisten it.
  4. Insert the catheter into your child’s trach. Only insert the catheter the length of the trach tube. Do not suction past the end of the trach tube.
  5. Place your thumb over the open port of the catheter to create suction.
  6. Begin pulling the catheter out using a circular motion. 
  7. Suction saline from cup through tubing to clean mucus out of catheter.
  8. Repeat suctioning until your child breathes easily. Insert and remove the catheter within 5-8 seconds. If the mucus is thick, use your saline bullet to put 2-3 drops of the saline solution into the trach. Then, attempt to suction again. NOTE: Saline solution should NOT be used routinely for suctioning.
  9. Allow rest periods between suctioning.
  10. Allow air to then be suctioned through the catheter to remove most of the saline from the inside.
  11. Replace the sleeve over the catheter.
  12. Hang the cath-in-sleeve in a safe place still attached to the suction machine. The cath-in-sleeve can be used for 24 hours then throw away.
  13. Turn off the suction machine.
  14. Use saline from a small container with a secure top for cleaning the catheter. Refill as needed for 24 hours. A clean container should be used daily.
  15. Wash your hands.

Special note for ventilators:

If your child is on a ventilator, you may need to bag him/her with a resuscitation bag several times after each time you insert the suction catheter. Attach the bag to the swivel and squeeze the bag until you see the chest rise. To suction, insert the suction catheter through the swivel cap.

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 09/2018

(757) 668-7000