Endotracheal and Tracheostomy Suctioning & Reinsertion Medical Directive

Question 1

ET and Trach Suctioning & Reinsertion MD

What are the indications for the endotracheal and tracheostomy suctioning & reinsertion MD?

Answer 1

Patient with endotracheal or tracheostomy tube
AND
Airway obstruction or increased secretions.

Question 2

ET and Trach Suctioning & Reinsertion MD

What are the conditions for suctioning?

Answer 2

N/A all through

Question 3

ET and Trach Suctioning & Reinsertion MD

What are the conditions for emergency tracheostomy reinsertion?

Answer 3

Other: Patient with an existing tracheostomy where the inner and/or outer cannula(s) have been removed from the airway
AND
Respiratory distress
AND
Inability to adequately ventilate
AND
Paramedics are presented with a tracheostomy cannula for the identified patient.

Question 4

ET and Trach Suctioning & Reinsertion MD

What are the contraindications to suctioning?

Answer 4

N/A

Question 5

ET and Trach Suctioning & Reinsertion MD

What are the contraindications to emergency tracheostomy reinsertion?

Answer 5

Inability to landmark or visualize.

Question 6

ET and Trach Suctioning & Reinsertion MD

What is the suctioning dose for <1 year?

Answer 6

Suction at 60-100 mmHg for 10 seconds, dosing interval of 1 minute for oxygenation.

Question 7

ET and Trach Suctioning & Reinsertion MD

What is the suctioning dose for ≥1 year to <12 years?

Answer 7

Suction at 100-120 mmHg for 10 seconds, dosing interval of 1 minute for oxygenation.

Question 8

ET and Trach Suctioning & Reinsertion MD

What is the suctioning dose for ≥12 years?

Answer 8

Suction at 100-150 mmHg for 10 seconds, dosing interval of 1 minute for oxygenation.

Question 9

ET and Trach Suctioning & Reinsertion MD

What is the maximum number of emergency tracheostomy reinsertion attempts?

Answer 9

2

Question 10

ET and Trach Suctioning & Reinsertion MD

What should you do prior to suctioning?

Answer 10

Pre-oxygenate with 100% oxygen.
In an alert patient, whenever possible, have patient cough to clear airway prior to suctioning.

Question 11

ET and Trach Suctioning & Reinsertion MD

What is a reinsertion attempt defined as?

Answer 11

The insertion of the cannula into the tracheostomy.