Suctioning trach while going in

[lisapicard]

The inline suction allows for continuous oxygenation. Can we apply suction while entering the trachea?

[JustBeachyNurse, LPN]

Yes. Suctioning on the way in an out reduces the potential for a mucus plug to be dislodged when inserting the catheter sans suction before you can remove it by suctioning on the way out. It's less traumatic to suction the way in and out according to current EBP

[GrannyRRT]

Suctioning is a breath taking experience. Not much air for oxygenation or breathing can happen around the catheter and tube. I will suction visible secretions going in only a short distance but will release the suction and withdrawal after a few seconds.

I also don't know very many caregivers for adults who document the length of the trach or ETT and suction only to that point such as neo/pedi people do. If you hit tissue going in with the suction applied, the risk for damage is greater. This is especially true for trachs which have a tendency to be malpositioned toward the tracheal wall due to the weight of a vent or aerosol circuit.

[JustBeachyNurse, LPN]

Suctioning is a breath taking experience. Not much air for oxygenation or breathing can happen around the catheter and tube. I will suction visible secretions going in only a short distance but will release the suction and withdrawal after a few seconds.

I also don't know very many caregivers for adults who document the length of the trach or ETT and suction only to that point such as neo/pedi people do. If you hit tissue going in with the suction applied, the risk for damage is greater. This is especially true for trachs which have a tendency to be malpositioned toward the tracheal wall due to the weight of a vent or aerosol circuit.

I only do pedi/infant I never realized providers don't take into consideration trach length! Our care plans specify trach length as well as maximum suctioning depth.

But I was in a training class with a cocky new RN that stated you need to insert the cath as "deep as possible" past the trach! The other nurses had combined experience that was more years than she was old and said "Nooooooooooo!!!!" Blood is bad! Random depth is bad! Trach tissue is delicate!

[nurseprnRN, BSN, RN]

Yes. Suctioning on the way in an out reduces the potential for a mucus plug to be dislodged when inserting the catheter sans suction before you can remove it by suctioning on the way out. It's less traumatic to suction the way in and out according to current EBP

Citation for this, please? It seems counterintuitive to be removing someone's functional reserve capacity for any reason.

[JustBeachyNurse, LPN]

Citation for this, please? It seems counterintuitive to be removing someone's functional reserve capacity for any reason.

I have to find my materials as this was at a recent inservice for infant/child trach vent and I know the research was cited I just have to find the document.