Let’s take another look at the typical airway anatomy to establish why suctioning is needed for children with tracheostomies and why it is so crucial to their survival. First, in the airway, there is something called the “mucociliary transport system.” This describes cells that are on the inside of the child’s airway that help to transport secretions (flem) up and out of the airway. For example, each day, our bodies develop flem, and sometimes, especially when we are sick, we cough it up. That is due to the mucociliary transport system that it is in your airway. Here is a picture depicting this system:
The arrow depicts the way that the mucus (flem) travels which is up and out of the airway. There are small hair-like particles that help move the flem up and out of the airway, as depicted in the picture. When a tracheostomy tube is put into an airway, this process is halted and it becomes much more difficult, and even impossible, to get mucus all the way out of the airway. This is because the tracheostomy tube does not have a mucociliary transport system. This is where suctioning comes into play. The child will begin to cough up secretions, but will need suctioning to get the secretions all the way out of the airway.
The following are criteria that can be used to help you know if your child needs suctioning:
· Noisy breathing
· Increased or decreased rate of inspiration (number of times the child breathes in in one minute)
· Decreased oxygen saturation
· Excess secretions
· Child is attempting to cough or clear secretions
· Child requests suction
· Coarse breath sounds (crackles). The following is a video of what coarse breath sounds might sound like:
· Noisy breathing
· Increased or decreased rate of inspiration (number of times the child breathes in in one minute)
· Decreased oxygen saturation
· Excess secretions
· Child is attempting to cough or clear secretions
· Child requests suction
· Coarse breath sounds (crackles). The following is a video of what coarse breath sounds might sound like:
It is important to stay up-to-date on basic suctioning practices. The following is a powerpoint with suctioning basics from the American Thoracic Society.
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References:
https://www.onlineexambuilder.com/suctioning-quiz/exam-20114
https://www.youtube.com/watch?v=5JA6D1Mguh0
http://ajcc.aacnjournals.org/content/12/3/212.full.pdf+html
http://web.b.ebscohost.com.byui.idm.oclc.org/ehost/pdfviewer/pdfviewer?sid=709d741f-a6f3-464f-b5f5-db8ef4520b96%40sessionmgr112&vid=9&hid=125