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The Importance of Suctioning

Because your child breathes differently with a tracheostomy, he or she needs help getting rid of mucus and secretions. By inserting a small suction catheter into the trach tube, mucus is removed and your child breathes easier.

When you first start using suction, you and your child may be uncomfortable with the procedure. Your child will probably cry or pull away. But remember, your child needs suctioning to breathe easier. Concentrate on what you are doing rather than how your child is behaving. After time, you will both get used to suctioning and it will become easier.

When your child first gets the tracheostomy, it will be necessary to suction several times during the day and night. After your child becomes comfortable with the trach, suctioning will become less frequent.

Suction only when necessary, not on a schedule, but at least several times a day. Judge the time interval between suctioning by the amount of secretions produced. Our experts recommend that you suction before bedtime, first thing in the morning, before meals, and before your child goes outside. If your child has a cold, suctioning should be done more frequently.

By suctioning effectively, you will decrease the chance of respiratory tract infections, such as pneumonia.

Warning Signs

Here are some signs you should watch for so you know if your child's trach tube needs suctioning:

  • You can either see or hear mucus bubbling out of the trach.
  • Breathing rate is faster or harder than usual.
  • Nostrils flare when breathing.
  • The skin around the trach sucks in when breathing.
  • Your child appears restless or looks frightened and upset.
  • Your child's face appears pale or the lips are bluish.
  • Your infant is having difficulty sucking on a bottle.

If any of these signs occur, suction immediately.

Steps to Suctioning

You will need the following supplies:

  • Suction machine
  • Saline
  • Catheter kit (gloves, catheter, cup for saline)

Follow these steps to ensure proper suctioning:

1. Wash your hands.

2. Turn on the suction machine.

3. Open a suction catheter kit.

4. Pour a small amount of saline into the cup from the suction catheter kit.

5. Put on a clean glove.

6. Pick up the suction catheter from the kit with your gloved hand and attach it to the connecting tube of the suction machine.

7. Suction some saline from the cup to test the suction and to wet the inside of the suction catheter so the secretions will go through the catheter smoothly.

8. Insert about 1 inch of the suction catheter quickly and gently into the trach tube. The length inserted should be approximately the length of the trach tube itself. Do not put your thumb over the catheter vent while you are inserting the catheter.

9. After inserting the suction catheter, cover the catheter vent with your thumb to apply suction. Pull and twist the catheter out slowly. Do not leave the suction catheter in the trach for longer than five to eight seconds.

10. Suction some saline from the suction cup to clear the mucus out of the catheter.

11. If necessary, suction again until the airway is clear and your child can breathe easily. However, let your child rest at least 10 to 15 seconds before repeating the procedure.

12. If your child's secretions are thick and hard to suction, place a few drops of sterile saline from the saline dropper into the trach tube and then suction again.

13. After you finish suctioning the trach, you may also need to suction your child's nose with the catheter if he or she has a large amount of nasal secretions. Only suction the noseafter you have finished suctioning the trach with the catheter.

14. Discard the catheter and glove.

15. Turn off the suction machine.

16. Wash your hands.

After Suctioning

Pay close attention to the odor and color of the trach secretions. If the secretions are foul smelling or thick yellow-green, call your child's doctor. Streaks of blood might also appear in the mucus. If this happens frequently or becomes worse, notify your doctor.

Older children should be encouraged to cough to clear secretions from the trach. Wipe the secretions from the surface of the trach and neck with a tissue. Coughing can help minimize suctioning so praise your child for an effective cough.