Which step is correct when suctioning a tracheostomy tube?

• A. Cover the suction vent during insertion
• B. Do not pull back before suction
• C. Pull back slightly, then cover vent to start suction
• D. Suction for 60 seconds

Answer: (C)

Suctioning a tracheostomy tube relies on getting the catheter into the right spot and using suction effectively without letting air escape through the vent. After you insert the catheter until you meet resistance, pull back a small amount so the tip sits where secretions tend to pool. Then cover the vent on the tracheostomy tube to start suction. Occluding that vent creates the negative pressure path that pulls secretions into the catheter as you gradually withdraw and rotate it. This sequence minimizes trauma, concentrates suction where secretions are, and prevents passive air flow through the vent from bypassing the suction.

Suctioning should be brief—about 10 seconds per pass—and followed by a rest to reoxygenate. Covering the vent during insertion would impede ventilation and is not appropriate, and a 60-second continuous suction pass is unsafe due to risks of hypoxia and airway irritation.