PURPOSE
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To ensure the patency of an altered airway and to minimize pulmonary complications.
EQUIPMENT
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Sterile tracheostomy suction kit
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Suction source with connecting tubing
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Sterile saline solution
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Gauze sponges (noncotton lined)
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Five cc sterile syringe/saline solution droperette
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Personal protection equipment (goggles, glasses, gloves, and mask)
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Ventilating bag
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Oxygen
PROCEDURE
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Saline solution (2 to 3 cc) may be instilled with a sterile syringe or saline solution droperette to stimulate a cough and loosen tracheal secretions prior to suctioning.
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Two-glove rather than one-glove suctioning technique is recommended to prevent exposure to infectious tracheal secretions.
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Suctioning is indicated when the patient has a productive cough, adventitious breath sounds (rhonchi) over the upper airways, secretions that are audible or visible, or increase in ventilator pressure.
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Gently advance the suction catheter until resistance is met and then withdraw the catheter slightly before applying suction.
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Interventions to thin pulmonary secretions include increased humidification and examination of the patient's general hydration status.
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When suctioning through a tracheostomy tube with an inner cannula, do not remove the cannula. The inner cannula remains in place during suctioning so that the outer cannula does not collect secretions.
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If oropharyngeal or nasal suctioning is required, complete after tracheal suctioning. Discard suction catheter. Do not reinsert catheter into trachea.
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Effective use of the ventilating bag requires a cuffed tracheostomy tube. Without the cuff inflated, the forced oxygen from the ventilating bag will escape around the tube with little or no effect on lung expansion.
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Bronchodilator treatments and chest physical therapy, if ordered, should be done prior to the suctioning procedure.