Proper tracheostomy care will enable the patient to breathe easier and help to prevent infection.
Supplies you will need
Your hospice nurse will provide you with a pre-packaged kit that usually contains:
- Sterile gauze pads
- Sterile gloves
- Trach ties and tapes
- Sterile cotton swabs (Q-tips)
- Pipe cleaner brush
- Sterile cup
You will also need:
- Suction catheter
- Hydrogen peroxide
- Extra gloves
- Suction machine
- Sterile saline solution
What to do
- Choose a clean, flat and smooth work area. A clean table will work.
- Elevate the head of the bed.
- Turn the machine on to be sure it is working. Be sure the container and tubing are attached
- Wash your hands.
- Explain to the patient what you are going to do even if you do not think they can hear you.
- Open the suction package. Use the wrapping as a clean work area. Locate the cup and saline solution.
- Put on your clean extra gloves (not sterile).
- To suction the patient:
- Keep one hand clean and hold suction catheter in it.
- Consider the other hand dirty and use it to connect the smaller suction catheter to the larger tubing already attached to the suction machine.
- Suction up a small amount of the saline in the suction tubing (this also will help to lubricate the tubing prior to insertion).
- Gently place the small suction catheter into the tracheostomy site and gently insert until the patient coughs.
- Pull the catheter back about one inch and then cover the hole in the suction tubing with your finger and gently rotate the catheter as you are removing the catheter from the patient.
- Repeat the procedure if the patient continues to be congested.
- Allow the patient to rest 3-4 minutes before suctioning again. Apply oxygen during rest periods.
- NEVER suction for more than 10 seconds.
- Turn off the suction machine and discard the suction supplies.
- Remove suction jar from machine. Empty contents into toilet. Rinse the jar and return to the suction machine.
- Take off the used gloves and throw away.
Additional instructions from your nurse
Observe for any changes in color or odor of tracheostomy secretions. If there is bleeding or swelling of the trach site, report this to your nurse.
Adapted from: Harkreader, H., & Hogan, A.M. (2007). Fundamentals of Nursing: Caring and Clinical Judgment (3rd ed.). St. Louis, MO: Saunders.