I need some advice on suctioning trachs

[Blackcat99]

According to the nursing book I studied, I am suppose to insert the suction tube with no suction and then twirl the tube between my thumb and index finger and suction on the way out of the trach and to only do this one time and throw away the suction catheter. I have been doing this and it seems that hardly anything actually comes out. Mom does the suctioning the way you would do a regular suctioning on someone without a trach. She goes in twice with the same suction catheter and she gets rid of a lot of mucus. Since Mom is actually getting good results with her way of doing it perhaps I should do what Mom is doing? Mom says each suction catheter costs $10 a piece.

[anangelsmommy, ADN, BSN, RN]

if I can offer one piece of advice too as a mom of a child with nursing care for 14 yrs....nothing worse than having a nurse come in and try to tell YOU that you are doing things wrong. just remember that the MOM always knows her child best!! and it IS HER child!! giver her that respect and YOU will always win in that household, trust me, she knows what works for that child. And over time, even if you know a better method, you may be able to win her trust and show her that method...once you have that trust. And it really is sooo true, having gone to nursing school AFTER having the child with nursing care, it is sooo often done very differently at home than it is at the hospital or just how it is taught in the books. doesnt mean it doesnt work or that it is wrong, just different.

anangelsmommy

[Blackcat99]

I am curious as to how often most patients in the home have to be suctioned. For example, there is a 6 year old patient who needs to be suctioned every 30-60 minutes. There is a 21 year old patient that only gets suctioned once at night. He doesn't need to be suctioned at all during the day!!!! Anyway, I am wondering how often your patients need to be suctioned? Does age have anything to do with it? Thanks:redbeathe

[caliotter3]

This is determined by amount of secretions. Patients that constantly produce secretions will need more frequent suctioning. I've had patients that needed almost constant suctioning as well as those who needed none. Depends on the individual.

[nursel56]

What Caliotter said, there's a huge variation from 1 person to another, just as the size and type of trach and vent circuit if they are on a vent.

In my experiences, suctioning at less than 2 hour intervals is more common than someone, such as your 21 yr. old, who needs suction only once in 24 hours. Adults generally need less suction at night. Everyone seems to have more secretions when they laugh, cry, are eating if they are on a po diet, increased humidity, illness (ie a cold or flu) and seasonal allergies. One lady I've known for a long time gets p--- at me because I say something funny while she is eating-- (but sometimes she thinks I'm funny when I'm not trying to be :)).

It's interesting-- if you are with a patient a while you might know they are coming down with something before they do by sometimes subtle changes in amount, consistency, color their secretions. Yes, that's what we deal with very often in home health patients. I did have one nurse co-worker a while back who wanted to hold the full cannister up to the ceiling light to determine "yellow" or "green". I said no, I'm good but thanks anyway.

[Blackcat99]

Thanks caliotter3 and nursel56.:redpinkhe Yes, when the 6 year old starts crying he really starts getting lots and lots of secretions. So it's usually about 2 hour intervals for most patients. Thanks so much for the information.

[MommyPrincessQueen]

As stated, you can't argue with Mom's successes but we are taught to only suction on the way out. My patient is on a vent and is 45 years old. He has 24/7 private duty nursing care and is frequently suctioned. We change his suction catheter every 24 hours routinely. When suctioning him, he asks that we suction for no more than 11 seconds at a time for his breathing sake, which is understandable. I get best results by twisting the catheter with suction on the way out. Sometimes after I find the spot that is suctioning all the secretions, I will let off the pressure, put the catheter back in and go over that spot to be sure I have suctioned everything out. Hope this helps you some.