1. 3. Tracheostomy tube suctioning and cleaning Tracheostomy tube – Inner cannula – Obturator – Ties – Fenestrations

2. 3. Tracheostomy tube suctioning and cleaning Removal of accumulated secretions – Patient comfort – Increased respiratory efficiency – Decreased risk of complete airway obstruction – Decreased risk of infection

3. 3. Tracheostomy tube suctioning and cleaning Suctioning procedure 1.Wash hands 2.Position patient in a semi-sitting position 3.Prepare materials 4.Attach catheter to suction tubing 5.Proceed with suctioning the sterile saline to moisten catheter

4. 3. Tracheostomy tube suctioning and cleaning Suctioning procedure 6.Cover the suction port with thumb while inserting the catheter and rotating it between the thumb and forefinger. Periodically release the suction pressure for a brief second. 7.Allow the patient to breathe or cough between suctioning.

5. 3. Tracheostomy tube suctioning and cleaning Suctioning procedure 8.Observe for sign of respiratory distress. If needed, use manual ambu-bagging. 9.Flush catheter with saline.

6. 3. Tracheostomy tube suctioning and cleaning Cleaning the inner cannula – To clear the airway of accumulated secretions and bacteria – Should be done twice a day – Done by immersing it in hydrogen peroxide and rinsing with normal saline The tracheostomy site should also be cleaned with sterile cotton buds and normal saline Soiled ties should be replaced

7. 4. Catheter insertion Females – Place the catheter in the urethral meatus – From the urethral meatus, the catheter should follow the direction of the urethra (proceeds slightly upward as it advances towards the bladder) – Half the catheter must be inserted before inflating the balloon

8. 4. Catheter insertion Males – The distal urethra should be placed in a slight stretch straight up to straighten the urethra – The catheter must be inserted at least 24 cm before inflating the balloon