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Tracheostomy suction: a protocol for practice

Joanna Ireton1

  • 1Respiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London.

Paediatric Nursing
|January 17, 2008
PubMed

Insights

This study outlines a safe suction protocol for children with tracheostomies, emphasizing evidence-based practices. It details recommended suction pressures, catheter sizes, and insertion depths to minimize risks for pediatric patients requiring airway suctioning.

Area of Science:

  • Pediatric Nursing
  • Respiratory Care
  • Clinical Protocol Development

Background:

  • Suctioning is a common procedure for children with tracheostomies, but carries documented risks.
  • Nurses require evidence-based guidelines to ensure safe and effective suctioning practices.
  • Existing protocols may not adequately address the specific needs of pediatric patients requiring airway clearance.

Purpose of the Study:

  • To propose a comprehensive, evidence-based protocol for suctioning self-ventilating children with tracheostomies.
  • To provide clear guidelines on equipment, pressures, and procedures to minimize suction-related risks.
  • To enhance the safety and quality of care for pediatric patients with tracheostomies.

Main Methods:

  • Development of a protocol incorporating preparation, equipment selection, suction pressures, procedure, and post-procedure assessment.
  • Recommendation of specific suction pressures based on age: 80-120 mmHg for adolescents, 80-100 mmHg for children, and 60-80 mmHg for neonates.
  • Advocacy for the use of three-holed catheters sized no larger than half the tracheostomy's internal diameter and limiting insertion depth.

Main Results:

  • The proposed protocol includes specific recommendations for suction pressures within lower research-suggested limits.
  • Guidelines are provided for appropriate catheter size and insertion depth to prevent airway trauma.
  • Routine saline instillation is not recommended as part of the suctioning procedure.

Conclusions:

  • Implementation of this protocol, supported by education and staff involvement, can improve the safety of suctioning for children with tracheostomies.
  • Continuous evaluation and modification of the protocol are essential for sustained improvements in practice.
  • Adherence to evidence-based guidelines is crucial for minimizing the risks associated with tracheostomy suctioning in pediatric care.

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