- Don appropriate body substance isolation
- Turn on the suction unit and adjust pressure to the appropriate level
- Measure the appropriate length of the suction catheter
- If the tube is fenestrated you must insert an unfenestrated inner tube to prevent the catheter from passing through the fenestration and causing an injury to the trachea
- Insert the catheter by guiding it gently into the tracheostomy tube, ensuring that the lateral and distal holes pass through the tip of the tube, using gradations on the catheter to guide you. Adults may pass a longer catheter through the tracheostomy tube, but in a child the carina is close to the tip of the catheter
- Be certain to only handle the proximal end of the catheter. Attempt to maintain a sterile field with at least one hand remaining sterile
- Discard the catheter if you have touched the tip before placing it through the tube
- When suctioning, place thumb over the valve on either the catheter or the suction tubing, without kinking the catheter (1)
- Do not use intermittent suction, as it is less effective and without benefit (8)
- Do not apply suction when inserting the tube. This can cause hypoxia or damage to the mucosa.
- Withdraw the catheter slowly through the tube while maintaining a vacuum.
- Do not rotate the suction catheter when withdrawing as both the distal and later holes allow circumferential suctioning.
- Suction for no more than 5-10 seconds, or based on a patient’s underlying medical problem. (1)
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