Keeping the airway patent is one of the most important skills that you will perform for the clients with tracheostomies. Sometimes clients are unable to remove respiratory secretions by coughing. Secretions might build up, causing an obstruction. Nursing interventions include aspirating the secretions with a suctioning device to prevent obstruction. Always check the policies and procedures at your facility for their specific requirements when performing this skill. Some important points to remember when suctioning a client's tracheostomy include the following:
- Suctioning irritates the mucosa and removes oxygen from the respiratory tract along with the secretions. This irritation can cause hypoxia. To prevent this complication, the client must be hyperoxygenated before, during, and after the procedure.
- Use a suction catheter that is ½ the inner diameter of the tracheostomy tube. The smaller catheter will not occlude the airway during the procedure.
- Limiting the amount of time the suction is applied is very important because oxygen is removed from the airway along with secretions. Extended suctioning time or incorrect technique might also cause the client to experience hypoxia. Suction should only be applied as the catheter is being withdrawn, never when it is introduced into the airway.
- Always use PPE and strict aseptic technique to prevent contamination or disease transmission.