The next step in assessing patency is to attempt to pass a suction catheter into the tube or stoma.

There are advantages and disadvantages of this technique.

Question: Why should you not just try and ventilate down the tube?

Answer

The next step in assessing patency is to attempt to pass a suction catheter into the tube or stoma.

There are advantages and disadvantages of this technique.

Question: Why should you not just try and ventilate down the tube?

Answer: Suction allows diagnosis and then treatment – removal of secretions and blood not relieved by removing the inner tube.

The soft suction catheter is extremely unlikely to enter the soft tissues of the neck, and thus create a 'false passage' (Fig 1), if the tube tip is displaced.

Attempts at ventilation are hazardous. If the tube tip is displaced, surgical emphysema will develop making a difficult situation worse, especially with a fenestrated tube.

An experienced responder may try gentle ventilation, because this has the advantage of capnography, but this cannot be recommended for all situations.

Fig 2 is a video demonstrating the correct suction technique.

The next step in assessing patency is to attempt to pass a suction catheter into the tube or stoma.

There are advantages and disadvantages of this technique.

Question: Why should you not just try and ventilate down the tube?

Answer: Suction allows diagnosis and then treatment – removal of secretions and blood not relieved by removing the inner tube.

The soft suction catheter is extremely unlikely to enter the soft tissues of the neck, and thus create a 'false passage' (Fig 1), if the tube tip is displaced.

Attempts at ventilation are hazardous. If the tube tip is displaced, surgical emphysema will develop making a difficult situation worse, especially with a fenestrated tube.

An experienced responder may try gentle ventilation, because this has the advantage of capnography, but this cannot be recommended for all situations.

Fig 2 is a video demonstrating the correct suction technique.