Table 6-16
- Suction as necessary to facilitate respirations. Explain to client what to expect.
Position: semi-Fowler’s to prevent forward flexion of neck, to facilitate respiration, to promote drainage, and to minimize edema.- Administer mist to tracheostomy because natural humidifying of oropharynx pathways has been eliminated.
- Auscultate for moist, noisy respirations because nonproductive coughing may indicate need for suctioning.
- Prevent hypoxia by administering 100% oxygen before suctioning (unless contraindicated).
- Use strict aseptic technique and sterile suctioning catheters with each aspiration; use sterile saline to clear catheter of secretions. Keep dominant hand gloved with sterile glove, nondominant hand with nonsterile glove to control thumb control of suction. Suction tracheostomy before nose or mouth.
- Do not apply suction when inserting suction catheter to prevent injury to respiratory tract and prevent loss of oxygen. Insert catheter about 5 inches (12.5 cm).
- If client coughs during suctioning, gently remove catheter to permit ejection and suction of mucus.
- Apply suction intermittently for no longer than 5–10 seconds because prolonged suction decreases arterial oxygen concentration. Allow 2–3 minutes between attempts.
- Cuff deflation: if high-volume, low-pressure cuffed tube is used, deflation not necessary. If other tracheostomy cuffed tube is used, deflate for 5 minutes every hour to prevent damage to trachea.
- Use caution not to dislodge tube when changing dressing or ties that secure tube.