The trachea, commonly known as the windpipe, is a tube about 4 inches long and less than an inch in diameter in most people. The trachea begins just under the larynx (voice box) and runs down behind the breastbone (sternum). The trachea then divides into two smaller tubes called bronchi: one bronchus for each lung.

The trachea is composed of about 20 rings of tough cartilage. The back part of each ring is made of muscle and connective tissue. Moist, smooth tissue called mucosa lines the inside of the trachea. The trachea widens and lengthens slightly with each breath in, returning to its resting size with each breath out.

Trachea Tests

•Flexible bronchoscopy: An endoscope (flexible tube with a lighted camera on its end) is passed through the nose or mouth into the trachea. Using bronchoscopy, a doctor can examine the trachea and its branches.

•Rigid bronchoscopy: A rigid metal tube is introduced through the mouth into the trachea. Rigid bronchoscopy is often more effective than flexible bronchoscopy, but it requires deep anesthesia.

•Computed tomography ( CT scan): A CT scanner takes a series of X-rays, and a computer creates detailed images of the trachea and nearby structures.

•Magnetic resonance imaging (MRI scan): An MRI scanner uses radio waves in a magnetic field to create images of the trachea and nearby structures.

•Chest X-ray: A plain X-ray can tell if the trachea is deviated to either side of the chest. An X-ray might also identify masses or foreign bodies.

How to Suction a Tracheostomy Tube

 

1.Explain the procedure to the patient and reassure him or her that you will interrupt the procedure if the patient indicates respiratory difficulty. Administer pain medication to postoperative patient before suctioning.

 2.Gather equipment and provide privacy for patient.

 3.Perform hand hygiene.

 4.Assist the patient to a semi-Fowler’s or Fowler’s position if conscious. An unconscious patient should be placed in the lateral position facing you.

 5.Turn suction to appropriate pressure.

 a.Wall unit

 

• Adult: 100 to 120 cm Hg

 •Child: 95 to 110 cm Hg

 •Infant: 50 to 95 cm Hg

 b.Portable unit

 

•Adult: 10 to 15 cm Hg

 •Child: 5 to 10 cm Hg

 •Infant: 2 to 5 cm Hg

 

6.Place clean towel, if being used, across patient’s chest. Don goggles, mask, and gown, if necessary.

7.Open sterile kit or set up equipment and prepare to suction.

 a.Place sterile drape, if available, across patient’s chest.

 b.Open sterile container and place on bedside table or overbed table without contaminating inner surface. Pour sterile saline into it.

 c.Hyperoxygenate patient using manual resuscitation bag or sigh mechanism on mechanical ventilator.

 d.Don sterile gloves or one sterile glove on dominant hand and clean glove on nondominant hand.

 e.Connect sterile suction catheter to suction tubing held with unsterile gloved hand.

 8.Moisten catheter by dipping it into the container of sterile saline, unless it is one of the newer silicone catheters that does not require lubrication.

 9.Remove oxygen delivery setup with unsterile gloved hand if it is still in place.

 10.Using sterile gloved hand, gently and quickly insert catheter into the trachea. Advance about 10 to 12.5 cm (4-5 inches) or until patient coughs. Do not occlude Y-port when inserting catheter.

 11.Apply intermittent suction by occluding Y-port with thumb and index finger of sterile gloved hand as catheter is being withdraw. Do not allow suctioning to continue for more than 10 seconds. Hyperventilate three to five times between suctioning or encourage patient to cough and deep breathe between suctioning.

 12.Flush catheter with saline and repeat suctioning as needed and according to patient’s tolerance of the procedure. Allow patient to rest at least 1 minute between suctioning, and replace oxygen delivery setup if necessary. Limit suctioning events to three times.

 13.When procedure is completed, turn off suction and disconnect catheter from suction tubing. Remove gloves inside out and dispose of gloves, catheter, and container with solution in proper receptacle. Perform hand hygiene.

 14.Adjust patient’s position. Auscultate chest to evaluate breath sounds.

 15.Record time of suctioning and nature and amount of secretions. Also note character of patient’s respirations before and after suctioning.

 16.Offer oral hygiene.