Trach capping and suctioning

[grentea]

So I changed units and I'm orienting on a new unit where there are a lot of trachs. I've been a nurse for a year and some change and I've had a trach patient here and there not one for a long term period of time. I had a pt last night who recently had his trach capped. I did his trach care after he had showered and he told me that the humidity in the shower caused a bunch of secretions to be broken up. I helped him with quad coughing but apparently that wasn't bringing up the secretions. He asked me to suction him and I did. I did this three times total in the night (with quad coughing him unsuccessfully and then suctioning him). A few times the quad cough got it all though. So at the end of the night, I just happened to be talking to the respiratory therapist and my preceptor about how many times I suctioned him, and the respiratory therapist was like, "You opened him up three times to suction him!?" To which I replied, I'm sure with a stupid look on my face, "Um, yeah, he needed it." She told me just to page her if he started begging to be suctioned because she didn't want him to be uncapped and next time I certainly will do that. I was bit too tired to process this at the end of my night, but I do think I was in the wrong with what I did. So my question is, should you suction someone who has their trach capped ONLY if they are in distress?

[MS._Jen_RN, ASN, RN]

Where I'm at we wound do exactly what you did. He needed it. When we were done, the cap goes back on unless his sats are down.

Jen

[scribblerpnp]

Where I'm at we wound do exactly what you did. He needed it. When we were done, the cap goes back on unless his sats are down.

Jen

:yeahthat:

Same where I'm at. I can't think of any reason the RT would make such a fuss about that.

[morte, LPN, LVN]

i had a patient once who liked to be suctioned because she got a buzz off the extra o2.....other than that.....this patient may be on a specific (sp) regimen...and the RT may at least need to know when this is happening....if they are tryng to wean from the trach etc...

[grentea]

Thank you everyone for your responses! Morte, the docs actually are trying to wean him off the trach so I think I can see where the RT was coming from. Although I suppose I wasn't completely in the wrong here. I just didn't want to see him suffocate on his own secretions. Next time, I'm going to page the RT when he asks to be suctioned, but if he's in some serious distress, I'll do it myself rather than wait for the RT. I was just worried I committed some sort of big nursing trach care sin in my relative inexperience with trachs, and I guess I didn't.

[zacarias, ASN, RN]

I am also new to trachs. I had a patient with a trach that had humidified air initially with inline suction. We would suction him every so often. He was not a new trach. I remember that you're supposed to give extra 02 when you suction but he was only hooked up to air, he never dropped sats. Is that extra 02 just for new trachs or patients with problems getting secretions out?

[morte, LPN, LVN]

I am also new to trachs. I had a patient with a trach that had humidified air initially with inline suction. We would suction him every so often. He was not a new trach. I remember that you're supposed to give extra 02 when you suction but he was only hooked up to air, he never dropped sats. Is that extra 02 just for new trachs or patients with problems getting secretions out?

the patient i was talkin about ws actually on a vent, so we gave them an extra "shot" of O2 with an ambu bag before suctioning....not sure this is common practice anymore...check wth a RT....