How deep do you suction and how often?

[CCHSMOM]

I was trained not to suction past the end of the trach, but I've seen nurses and RT's suction my daughter much deeper than that when she's in the hospital. Also I've been told by many RT's that suctioning begets suctioning, while others say to suction any time you hear anything. I try to suction only when my daughter's vent pressure is over 35-40 or if she sounds or looks like she needs it.

What do you do?

[jamie]

The nurses always suctioned Evan too deep and often scratched his trachea. I think it is the rule to go only to the end of the trach tube.

[Kamilah's Mommy]

I don't suction past the end of the trach, but sometimes if I can hear something and I'm not getting anything out, I do go just a little bit deeper. They told us not to do deep suctioning because you can cause more problems. Kamilah doesn't need to be suctioned that often during the day. It's in the morning when she is the most junkie, so I suction her and only suction her again if she needs it or if its been awhile since I last suctioned her.
I was also told not to suction her often because she would have more secretions .

[kadiera]

Suctioning here has varied everywhere from every 5 minutes to every 6 hours, depending on illness, humidity, and what's attached to the trach (pre-vent weaning, it was every 6 hrs or so, early trach nose was every 5 minutes, with PMV it's every couple of hours, etc)

We were told not to suction past the end of the trach; we've seen people go deeper and cause bleeding. I'm told that on adults it's common to go much deeper.

[Momoffive]

I only voted on how I suction and level of agreement on the how to, because frequency varies so much here. Also, some nurses chart how many times they go in to suction with the same catheter, and others chart per catheter used, so on any given day, from the nursing pov, I am never sure how much suctioning has been done. It's also intersting to hear a nurse say with alarm that he needed SO MUCH suctioning.....and it's been about 5 times, which is fine. Robin is now encouraged to cough up as much as he can (e.g. into a tissue or paper towel), and some chart that as a suction, some don't. When he was little, there were nurses who thought they knew better and would suction past the end of the trach, cause bleeding, and be offended when I would take the catheter and show them (again) how far they were to suction. I am also not opposed to using a squirt of saline (called "bronchial wash" here) because he has a good cough and it def. helps bring up stubborn secretions.

[Niff]

We suction slightly past the end of the trach. Our instructions were to suction enough so that the holes on the end of the suction cath went past the trach.

And we suction as often as Mackenzie needs it. Sometimes it's upwards of 5x an hour, sometimes once an hour.

[CCHSMOM]

I was also taught to use a little saline before suctioning. I agree that it definitely helps loosen things up. I should have asked about that on the poll too.

I was also wondering how many of us use the in-line suction catheters. They are a pain when the tip gets blocked by a really sticky bit of mucous, but they are so much easier to use overall.

[Kamilah's Mommy]

We use the in-line suction catheter.

[bryantem]

I try not to go past the end of the trach tube. Lately Addisyn needs to be suctioned less than 10 times a day. It all depends on what she is doing. It is 12 and the last time I remember suctioning her was a few hours ago.

[Niff]

We used to use inline caths when Mackenzie was inpatient. Not to offend anyone, but I think they're major pieces of.... crap. You can't swirl it around to get all the secretions inside the trach. Mackenzie plugged and went into respiratory distress because of an inline cath not sufficiently clearing her secretions (and us not knowing it was subpar). I will NEVER use one again.