Mucus produced in the trachea and bronchi is transported up to the larynx by the ciliated mucosa of the trachea. This mucus blanket is disturbed following tracheostomy by:

• Loss of normal humidification from the nasal airway
• Post-surgical inflammation
• Paralysis of the cilia that are in contact with the tracheostomy tube
• Loss of a normal cough

Mucus collects at the lower end of the tracheostomy tube. Some patients may be able to project the mucus through the tube by forced expirations, but most often it must be removed by suction.

Frequency of suctioning varies between patients and over the course of their illness.

What sort of signs or symptoms suggest suctioning is required?

Answer