By Adem Lewis / in , , /

Hi my name is Erica Alexander and I am
one of the faculty here at Blessing- Rieman College of Nursing and Health
Sciences. Today I’m going to show you how to suction a patient via a tracheostomy. The
first thing you need to do is gather your supplies. You will need some saline
and a suction kit and you’ll need to make sure you have suction setup in the
room. After you have your supplies, you will do your hand hygiene and perform
your AIDET. The first thing you’re going to do to prepare your supplies is to open up your suction kit. You’re just gonna take the top off of it and you’ll
see inside that has a catheter and a set of sterile gloves. So you’re gonna
carefully pick up the sterile gloves without touching inside of the kit and
set those off to the side. Then you can go ahead and open up your normal saline
and pour that into the container. You just need enough the purpose of this is
going to be to provide a little bit of lubrication to the catheter and it’s
also to check your suction and to clean the catheter after you suction then to
clean the suction tubing. So once you’ve done that you’re ready to put on your
sterile gloves. So now you’re ready to apply your sterile gloves so I’m just gonna kind of push stuff out to the side sometimes these gloves are packed really
tight in this package so it’s always a good idea to bring an extra pair with
you just in case you’re not able to find the cuffs or you accidentally
contaminate these while you’re getting them on. Remember to only touch on these flaps
here so that way that closes like that it won’t contaminate. Then it’s a matter
of putting them on like any other pair of gloves; pinching the cuff to start
with. And you can see I kind of have my fingers messed up in this one a little bit but that’s okay I can fix that in a minute. Then pulling that one on, and that
one kind of did the same thing, but I can just fix those it’s not a big deal. Then I’m going to get the suction catheter in my hand. Since I have my sterile gloves on I can touch it however I need to. How I like to hold it, just make sure it
doesn’t touch your arm down here, I believe that just touched my arm just a
little bit so I would need to start over again. So just be mindful when you’re doing that that this doesn’t happen; if that
happens where the catheter is rubbing your arm you would have to start
over. So we’ll say that I have a new catheter. And you’ll want to kind of wrap
that up in your hand; however, you want to that feels comfortable to you. What I
usually do is I make sure that it’s in my dominant hand and I make sure that
I’m able to with my index finger and thumb get a good handle on where the
suction will connect so that way I have enough pressure I can get a good enough
hold to connect the two. So then I will go ahead and get my suction and connect
that. Now your non-dominant hand is going to become your dirty hand and that can
stay here on the suction tubing and right here but it should not go up any
further than that. And then you would use your sterile hand to suction. I would test the suction by putting it into the container with a saline and
then applying my thumb to the little hole here that will create the suction. Then I’ll be able to make sure that it’s working and then you can take your
finger off of that your thumb and get the end of that a little bit wet it’ll
make it a little bit easier to insert; you don’t want it you know dripping
crazy wet just so that way it’s been in there and it’s not completely dry going in. Now you’re ready to suction your patient. So you’re gonna make sure that your thumb is not on the suction regulator because you only want to apply suction when you’re withdrawing the catheter and not when you’re inserting
it and that’s to minimize oxygen loss. So you’re gonna insert the catheter making sure that you go directly into the trach and you don’t touch anything. Your
patient may start to cough and that’s when you’re ready to stop and you can
start to pull back and suction. If you meet a little resistance, that means you’re at
the carina and what you want to do is you want to pull back just a touch
before you start to apply the suction. Then you’re gonna apply the suction
while you withdraw the catheter in a circular motion no more than ten seconds. The maximum amount of ten seconds is so that way you can minimize oxygen loss as
well. So then I would go ahead I’m gonna come over here to my saline and I’m
going to apply the suction that’s gonna help relubricate the catheter it’s
also gonna clean out the catheter as well as the suction tubing. Give
your patient a couple minutes and see if they need suctioned again. If they need
suction again, then again we’re gonna only suction on our way out so my thumb
is off. I’m going to insert it until they cough or meet a little resistance, pull back,
apply the suction and come out for a maximum of 10 seconds. Then you’re gonna clean that suction catheter out again; even if it’s your last time because you
want to get all the suction tubing cleaned. And if it is your last time then
you can disconnect this and throw away the catheter itself. There are a couple other things to consider when suctioning the patient. If your patient
is receiving oxygen you may want to increase that oxygen up to a hundred
percent oxygen for a few minutes before suctioning and between each suction pass that you make and for a couple minutes after suctioning to help with that
oxygen loss that they may experience during the suctioning process. If your
patient is on a ventilator there’s typically a button on the ventilator
that you can push that will say hyper oxygenate, or something similar to that
effect, and it will increase the oxygen for you and it will automatically take
it back down as well. So just keep that in mind when you’re suctioning a patient,
you always want to be mindful of their respiratory status and make sure they
are tolerating the suctioning well. And that is how to suction a patient via a
tracheostomy. Thank you for your time.

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