Trach Suction Tube Techniques

Suctioning a trach tube can help keep tracheostomy patients healthy, clear the airway, and reduce the risk of serious infections. Many trach patients are able to suction their own tubes at home. Some need the assistance of medical providers, especially when they are hospitalized, suffering respiratory distress, or have other comorbidities. Here’s what you need to know about trach tube suction. 


When to Suction 

At a minimum, suction a trach tube when the patient awakes in the morning and before they retire for the evening. It is also important to suction the tube when the patient displays the following suction indications: 


  • Difficulty breathing 
  • Hypoxia
  • Audible breath sounds and an inability to clear the airway
  • A moist cough


New: Ultimate Guide To Purchasing A Portable Emergency Suction Device


How to Suction 

The suctioning procedure is essentially the same regardless of the reason you are suctioning and the type of equipment you are using.


Follow these steps


  1. Wash your hands and put a glove on your dominant hand. 
  2. Power the machine on and set it to the low or medium setting with your ungloved hand.
  3. Pick up the hard plastic end of the catheter with your gloved hand. Attach it to the connecting tubing. Be sure only to touch the connecting tubing with your ungloved hand since it is not sterile.
  4. Wrap the catheter around your gloved hand when not in use to avoid contamination of the catheter.
  5. Dip the suction catheter into sterile water and tell the patient to take several deep breaths. 
  6. Push the suction catheter into the tracheostomy tube as far as it will go without force. Avoid covering the suction vent while placing the tube. 
  7. Withdraw the catheter slightly before suctioning. 
  8. Place your thumb over the vent to begin suctioning. Limit suctioning passes to no longer than 10 seconds at a time. 
  9. If there is any pulling during suctioning, stop suctioning. 
  10. Wait 20-30 seconds between suctioning passes. If it is necessary to suction the patient more than three times, wait another 10 minutes before suctioning. 


Suctioning can be scary, especially to new trach tube patients. Always tell the patient what you are doing and maintain a calm demeanor, particularly if the patient is combative or afraid. Most patients can learn to suction their own tube, so offer to walk them through the process. 


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Suction-Related Infection Prevention 


The COVID-19 pandemic illuminated the critical role infection prevention plays in all aspects of medical care. Trach patients are highly vulnerable to communicable diseases. Even minor infections can become life-threatening. Moreover, they can transmit infections to their care provider, so the value of thoughtful infection prevention runs in both directions.


To reduce risk to both patients and providers: 


  • Wash hands and change gloves after touching the patient, before changing tubing, and before and after touching anything that could be contaminated. 
  • Follow your agency’s rules for disposal of hazardous waste. 
  • Store your suction machine in a sealed container away from patients and potential contaminants. 
  • Never reuse disposable equipment, even in an emergency. 
  • Sterilize all reusable equipment immediately after suctioning the patient. 
  • Wear protective gear when suctioning the patient. 
  • Avoid treating or interacting with patients when you have any signs of illness, especially a fever. 


The Right Equipment is Essential

A portable emergency suction device enables you to suction patients wherever they are, without the stress and trauma of transporting them. The right machine offers reliable and consistent suction so you can keep patients safe. It should also retain a lasting charge so that dead batteries don’t endanger the communities you serve.


We recommend storing your machine with a variety of catheters so you can act quickly when patients need help. For assistance choosing a portable suction machine that is compatible with the equipment you already have, download our free e-book, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.


Editor's Note: This blog was originally published in August 2020. It has been re-published with additional up-to-date content.