How to Suction a Pediatric Patient's Trach Tub

A tracheostomy can save a patient’s life, improve their quality of life, and help them live more independently. Yet this vital medical device also increases the risk of certain infections, especially pneumonia


Suctioning a trach tube when a patient cannot clear their airway can greatly reduce the risk of certain infections while helping them remain more comfortable. Here’s what you need to know about how to suction a pediatric patient’s trach tube. 


Know When to Suction the Trach Tube 

Mucus can accumulate at night as a child sleeps, making it more difficult to clear the airway. For this reason, you must suction the trach tube at least twice a day—in the morning when the child wakes up and at night before they go to sleep. Additionally, suction the child under the following circumstances:

  • They make sounds indicating they cannot clear the airway, such as gurgling or a moist cough. 
  • They ask to be suctioned. 
  • Before (and sometimes after) changing the tube. 
  • Before meals. 
  • The child has trouble breathing or seems anxious or uncomfortable. 
  • The child’s nostrils flare or they show other signs of breathing difficulties, such as grunting or retractions. 
  • The tube clogs or you can hear mucus inside the tube. 
  • The child shows signs of cyanosis. 


Communicate with the Patient and Their Caregiver 

Medical providers sometimes forget that even when they cannot speak, tracheostomy patients can see and feel what is going on. Children have complex emotional needs, and a child’s medical experience may affect how they feel about doctors and other providers for the rest of their life. 


For this reason, it is critical to be kind and gentle. Never ignore the child or talk about them as if they are not there. Instead, practice good communication skills: 

  • If the child is anxious, wait until there is a caregiver present. 
  • Ask the caregiver’s permission. Don’t just walk in and suction the child. 
  • Explain the procedure to the child in simple, age-appropriate language. 
  • Ask the child if they are ready to be suctioned. 
  • Be gentle and kind. Never threaten or punish the child. 
  • If the child does not want to be suctioned, remain calm and consistent. Explain that this is important for their well-being and will be over quickly. 
  • Praise the child afterward, no matter how they behave. 
  • Get to know the child, especially if they are in your care for days or weeks. Learn about their hobbies. Call them by name. Establish a connection. Children trust and like people who treat them like human beings. 


Follow the Right Trach Tube Suctioning Procedure 

To suction a pediatric patient, practice diligent hygiene, wearing appropriate personal protective equipment and washing hands before and after touching any equipment. Then follow these instructions: 

  1. Place the patient in a stable, supported position. 
  2. Fill a cup with distilled water, then use gloves. 
  3. Ensure cuffed tracheostomy tubes are inflated. 
  4. Connect the suction catheter to the connecting tubing. Wrap the catheter around the gloved hand when not in use to reduce the risk of contamination. 
  5. Expose the tracheostomy opening then turn on the suction machine. 
  6. Insert the catheter into the opening until you notice resistance. Do not suction as you are inserting the catheter. 
  7. Cover the suction vent to begin suctioning the patient. 
  8. Remove the catheter, slowly rotating it. Suction the patient as you withdraw but never suction for longer than 10 seconds. 
  9. Clean the catheter in distilled water between each suction pass. 
  10. Allow the patient 20-30 seconds of rest between each suction pass. 
  11. Never store any equipment unbagged and don’t put used equipment back in your kit. 


Use the Right Equipment

A portable suction machine can help you suction a child without moving them, especially when treating tracheostomy patients at home. No two portable suction machines are exactly alike. You need one that offers consistent, reliable, comfortable suction and that won’t lose suction over time. 


For help selecting the right device for your agency, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.