Abstract
The risks of suction are weil documented. Nurses caring tor children with tracheostomies must use their clinical
judgement as well as a sate suction procedure based on evidence. Preparation, correct equipment and suction
pressures, a sate suction procedure and post-procedure assessment are included in a proposed protocol tor a
selt-ventilating child with a tracheostomy. Suction pressures are recommended at the lower limits suggested
by research, i.e. pressures ot 80-120mmHg (10-16Kpa) tor adolescents, 80-lOOmmiHg (10-13Kpa) tor chiidren
and 60-80mmiHg (8-10Kpa) tor neonates. Three holed catheters are advocated ot a size no larger than halt
the internal diameter ot the patient's tracheostomy it is recommended that the suction catheter not be
inserted turther than the end ot the tracheostomy tube. Routine instillation ot saline is not recommended. A
combination ot education, staff involvement and mechanisms tor audit, evaluation and modification ot the
protocol are required to support implementation ot the protocol and improvements in practice