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 should be applied to patients who are not currently using mechanical ventilation.
Closed suction should be applied to patients who are currently using mechanical ventilation.
Subglottic suction should be applied to patients who have their cuff inflated and who have a tracheostomy tube with subglottic suction port.