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CION Cancer Clinics
Suctioning a tracheostomy at home: how to do it safely | CION Cancer Clinics
Suction is needed when mucus collects in the tracheostomy tube and the person cannot cough it clear. You will hear a rattle, see them working harder to breathe, or notice mucus at the opening. A short, gentle pass with a fresh suction catheter clears it. This page covers when to do it, how, when to stop, and what to do if the tube will not clear. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- When does a tracheostomy need suctioning, and why?
- How do you suction a tracheostomy at home?
- How do you know when to suction, and when to stop?
- Suction words, in plain language
- Four things families tell us, and what is actually true
- What this page cannot tell you
- Common questions about suctioning at home
The short answer
When does a tracheostomy need suctioning, and why?
Suction is needed when mucus collects in the tube and the person cannot cough it out. You will hear it as a rattling or bubbling sound, see them working harder to breathe, or notice mucus at the opening. A short, gentle pass with a thin suction tube clears it.
Why the tube fills up in the first place
The nose normally warms, moistens and filters every breath. A tracheostomy bypasses the nose, so drier air goes straight into the windpipe, and the lining makes more, thicker mucus to cope. A strong cough clears most of it. After a big operation the cough is often not strong enough, and suction does the job the cough cannot.
What suction is, and what it is not
Suction clears the tube itself, and only the tube. It does not reach deep into the lungs, and it should not. Some people need it many times a day in the first weeks and hardly at all later. Your team will show you on the ward, and you should do it in front of them at least once before you go home.
Suction is done when it is needed, not on a fixed timetable. Suctioning a clear tube irritates the lining and makes more mucus.
!
One thing that cannot wait
If the suction tube will not pass down the tracheostomy, or the person is struggling to breathe, going blue around the lips, or cannot get air through the tube even after suction, the tube may be blocked. Take out the inner tube if there is one. If breathing does not ease at once, call the emergency number and start the blocked-tube steps you were taught. Do not keep trying to suction a tube that will not clear.
Not sure whether this applies to you?
Ask an oncologistStep by step
How do you suction a tracheostomy at home?
Get ready
Wash your hands. Switch on the suction machine and check it pulls at the setting your team marked. Open a fresh suction catheter without touching the tip. Sit the person up if they can manage it.
Pass the catheter
With your thumb off the side hole so there is no suction yet, slide the catheter gently into the tube to the depth you were shown, usually just to the end of the tube itself. Never force it.
Suction on the way out
Cover the hole with your thumb and draw the catheter back slowly, rolling it between your fingers. Keep the whole pass short, a few seconds only. The person cannot breathe well while it is in.
Let them recover
Wait, let them take a few breaths, and look at them, not the machine. If they still sound wet, use a new catheter and go again. Two or three passes is usual. More than that means something else is going on.
Clean up
Flush the tubing with clean water, bin the catheter, wash your hands. Note the colour and thickness of what came out. That record is useful at the next clinic visit.
Reading the signs
How do you know when to suction, and when to stop?
Signs suction is needed
A rattle or bubbling with each breath. Mucus visible at the tube opening. Faster or harder breathing. Restlessness, especially at night. A cough that keeps starting but never clears anything.
Signs you are suctioning too much
Streaks of fresh blood on the catheter. A tube that sounds dry and whistles. Coughing that starts the moment the catheter goes in and brings up nothing. Ease off and check the humidification instead.
What the mucus tells you
Clear or white and thin is normal. Thick and sticky usually means the air is too dry. Yellow or green, more than before, or with a smell, can mean a chest infection.
Ring the team the same day for
- A change to yellow or green with a fever
- More than streaks of blood
- A sudden rise in how often suction is needed
What to keep within reach
The machine and its charger, a box of catheters, clean water in a covered jug, gloves, tissues, and the spare tubes. Keep the kit on one tray so nobody has to search for it at three in the morning.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Words you will hear
Suction words, in plain language
- Catheter
- The thin, soft, single-use tube that goes into the tracheostomy. The team tells you which size to buy.
- Shallow suction
- Passing the catheter only as far as the end of the tracheostomy tube. This is the method taught for home, because going deeper can injure the windpipe.
- Suction pressure
- How hard the machine pulls, shown on its dial. Too high damages the lining. The ward sets it and marks it before discharge.
- Clean technique
- Washed hands, a fresh catheter for each pass, and nothing touching the catheter tip. This is what home care needs. Sterile gloves and gowns are for hospital.
- Saline drops
- A few drops of salt water put into the tube to loosen thick mucus. Most teams no longer advise it routinely. Use it only if you were told to, and in the way you were shown.
- Secretions
- The word the team uses for mucus.
Commonly believed
Four things families tell us, and what is actually true
"We suction every two hours to be safe."
Suctioning a clear tube does harm. It scrapes the lining, makes more mucus and can cause bleeding. Suction when the signs are there, and not otherwise. A quiet night with no suction is a good night.
"The deeper the catheter goes, the better it clears."
Deep suction reaches the fork of the windpipe and can injure it, drop the heart rate or trigger a spasm. Home suction goes to the end of the tube and no further. That is where the mucus that matters collects.
"If there is blood, we must have done it wrong."
Small streaks after suction are common, particularly in the early weeks and in dry weather. They usually mean the lining is irritated, and better humidification settles it. Bright red blood that keeps coming is different, and needs a call the same day.
"Only a nurse should be doing this."
Family members suction safely at home across Telangana every day. The skill takes an afternoon to learn. What matters is that you were shown, that you did it under supervision before discharge, and that you have a number to call.
Being straight with you
What this page cannot tell you
This page cannot tell you the catheter size, suction pressure or insertion depth for your own relative. Those depend on the tube they have, and they are written on the discharge sheet. If that sheet is missing, ring the ward before the first suction at home, not after.
Who should not be suctioning at home yet
Anyone who has not done it in front of a nurse. Anyone caring for a person on a ventilator at home, where the team usually arranges trained help. And anyone who cannot get to a phone and an emergency route quickly, because a blocked tube is the one thing that cannot wait.
What to ask before you leave hospital
Which catheter size, how deep, what pressure, and how often is too often. Where to buy catheters near your home. What the blocked-tube steps are, in order. Ask for these in writing, and photograph the sheet so it is on every family phone.
If the person is on a ventilator at home, or has a cuffed tube with the cuff up, the routine is different. Follow the plan you were given for that, not this page.Questions we are asked
Common questions about suctioning at home
How many times a day is normal?
There is no normal number. Some people need suction several times an hour in the first days home and once or twice a day a month later. What matters is the trend. If the need suddenly rises, or the mucus changes colour, ring the team.
Does it hurt or frighten the patient?
It is uncomfortable rather than painful, and it makes most people cough. The cough is useful, because it pushes mucus up to where the catheter can reach. Tell them before each pass, keep the pass short, and let them breathe between passes.
Can I reuse a suction catheter?
Use a fresh one for each session, and a fresh one for each pass if the first is clogged. Reusing catheters raises the chance of a chest infection. If cost is the worry, tell the team.
The mucus is very thick. Should I put water down the tube?
Only if your team told you to, and only the way they showed you. Thick mucus almost always means the air is too dry, and the fix is better humidification through the day, not water at the moment of suction.
What if the power goes off?
Most home suction machines run on a battery for a while. Keep it charged, and keep a hand-operated suction pump in the kit as a backup. In a district with long power cuts, ask the supplier about a machine with a longer battery before you buy.
Should I suction before meals or before sleep?
Before a meal, yes, if the tube sounds wet, because a clear tube makes swallowing easier. Before sleep, only if the signs are there. Suctioning on a routine irritates the lining. What does help at night is a working humidifier and the person lying slightly propped up.
Can the patient learn to suction himself?
Many people do, using a mirror, once they are strong enough and have the hand control. It gives back a lot of independence. Ask the nurse to teach the patient as well as the family.
What do I do with the used catheters and mucus?
Empty the machine's collection jar into the toilet, rinse it, and wash it daily. Catheters go into a sealed bag and then household waste. Wash your hands after all of it. There is no infection risk to the family from ordinary tracheostomy mucus handled this way.
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Sources
- NHS — Tracheostomy
- National Cancer Institute — Tracheostomy (NCI Dictionary of Cancer Terms)
- American Cancer Society — Surgery for laryngeal and hypopharyngeal cancer
- Macmillan Cancer Support — Head and neck cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Blocked Tube: The Emergency Every Family Must KnowWhat to do when suction does not clear the tubeHumidification and Preventing CrustingWhy thick mucus usually means dry airCleaning the Inner TubeThe other daily job that keeps the tube clearTracheostomy Supplies and Cost in HyderabadWhere to buy catheters and what they costCaretaker and Family Guide to SurgeryFor the relative doing the day-to-day care
Talk to us
Going home with a tracheostomy and not sure you are ready?
Call the helpline. A tracheostomy nurse or surgical oncologist will go through the suction plan with you, check your discharge sheet and tell you what to ask the ward. One helpline serves every CION centre.