Trach suctioning without gloves??

HopefulRN7 · Dec 3, 2015

i worked in private duty as well and we never wore gloves while trach suctioning.... the parent (who was also a peds nurse) didn't find it necessary since all the catheters had sleeves on them. this child would cough and gag suddenly and quickly though so many times there wasnt a chance to don gloves. just had hand sanitizer less than a foot a way at all times!

I'm assuming you were using the closed (in-line) suction catheters when you refer to the sleeves vs the single use varieties. If that's the case, I can totally agree with you that gloves are not necessary because the catheter is contained and not causing germ exposure to the patient or the nurse if the procedure is executed properly.

Gotta love those, wish all my Pedi's were candidates for them!

Flatlander · Oct 8, 2017

I always have to fight my agency to supply enough gloves for home care. I recently researched this subject online and the recommendations vary site to site. However all were in agreement that it is important not to contaminate the new trach by allowing it to touch anything unsterile, presumably because it will remain in place for awhle and allow chance for contaminants to cause infection. The other agreement was using a new sterile suction catheter each time.

I am still confused. Wish my agency had written protocols and standards. One option I've tried is to call the physician who prescribes the trach care and ask their staff for what they recommend and teach families. Sometimes they will send a copy of their home care instructions. By following doctor recommendations maybe then you are covered if there is a licensing/standards issue against you.

Wlaurie, RN · Nov 9, 2017

Didn't wear gloves for pt that had a ballard. The pt I have now gets oral nares suctioning and I always wear gloves. She also has MERSA. Protection goes both ways.

Crystal-Wings, LVN · Nov 23, 2017

When I did suctioning on the vent case I used to do I didn't wear gloves. The family didn't and the other nurse didn't. Only time they wore gloves was when the trach was changed, but I never did that because I worked the night shift and it wasn't changed then.

Flatlander · Nov 24, 2017

I agree this seems to be the standard nursing practice.

LilyRN99 · Dec 8, 2017

I wear gloves with standard suctioning. The catheters are often reused.

Dlowe · Feb 28, 2018

I glove the hand that I am handling the catheter with unless it's an urgent need for the patient. The family I work with does not use gloves and have mentioned they are comfortable with me not using gloves as it is a sleeved catheter. Of course if my hands are visibly or otherwise soiled I use gloves.

mdrnrn · Mar 13, 2020

I've had much more experience in home care than in the hospital setting at this point, and there is no textbook or printed reference material that I've found that I can study to learn proper home care technique. ** I was trained for home care by my patient's mom.** Therefore, I've never put on gloves to suction my pediatric patient's nose or mouth with a Little Sucker or Yankauer. We use gloves, just one on the hand holding the trach suction catheter, for tracheal suction. I'd want to wear gloves for an adult patient but for a well (non-infectious) child it felt okay to go without. Does anyone have a link to reference material? Any more thoughts? Thanks.

allnurses Guide · Mar 15, 2020

On 3/12/2020 at 8:06 PM, mdrnrn said:
I've had much more experience in home care than in the hospital setting at this point, and there is no textbook or printed reference material that I've found that I can study to learn proper home care technique. ** I was trained for home care by my patient's mom.** Therefore, I've never put on gloves to suction my pediatric patient's nose or mouth with a Little Sucker or Yankauer. We use gloves, just one on the hand holding the trach suction catheter, for tracheal suction. I'd want to wear gloves for an adult patient but for a well (non-infectious) child it felt okay to go without. Does anyone have a link to reference material? Any more thoughts? Thanks.

Hi mdrnrn!

It sounds like the way your patient's mom taught you to suction is the most commonly used, with the exception being whether you wear one glove or two. We use clean technique rather than sterile technique.

The issue we often run into is that it's common to find families operating on pre-set supply limits their insurance will cover, so wearing 2 gloves out of the box for each suctioning could mean running out altogether.

When I started doing private duty home care one of the first things our DON stressed was that the primary caregivers, parents etc in long term cases have usually worked out the best approach through experiencing what works and what doesn't as each home care case is unique. Unless the situation is obviously dangerous we work with the family.

Although I've looked, I haven't found hard and fast references on the topic. As you said, any new routine would have to include everyone who takes care of that child.

Welcome to allnurses! Hope that helps some.

amoLucia · Apr 8, 2020

On ‎12‎/‎1‎/‎2015 at 12:53 PM, Girlafraid13 said:
I've only done in an emergent situation. (Ex:Pt starts coughing formula through trach)
I've seen nurses and parents do it I've seen nurses leave the cath hanging on the suction machine touching everything, being contaminated by everything (biggest pet peeve)

Am reading this late - BIGGER pet peeve occurred when the collection canister was NOT emptied after EACH use (DON'T start me about end of shift!).

Will also reinforce PP nurseI56's comment that insurance often predicates the allotment of supplies that are sent/reimbursable for care. So frugality is THE RULE when using supplies. Personally, I know this one well.

And for the record, I also learned how to glove-suction one-handed, even when I worked in NH/LTC. Supplies were freq super limited or even unavail on NOCs.