Assess the need for suction at least 2 hourly. Suction should not be performed routinely, but only when the patient requires it.

The frequency of suction varies widely between patients. Providing suction uses an aseptic non-touch technique and the suction pressure ideally less than 20cmH₂O.

Suction may need to be applied to two sites: the lumen of the tracheostomy tube where secretions may gather in the trachea, and above the cuff of a tracheostomy tube where secretions may build up from the upper airway.

Open suction:

Open suction should be applied to patients who are not currently using mechanical ventilation.

Closed suction:

Closed suction should be applied to patients who are currently using mechanical ventilation.

Subglottic suction:

Subglottic suction should be applied to patients who have their cuff inflated and who have a tracheostomy tube with subglottic suction port.