Suction Stories Part 2: Tracheal and Pharyngeal Suctioning (Closed Suction System) on an EVAC ETT 

Not really but good oral care and and diligent suctioning may make it less odorous. If there is a really nasty smell and the colour or consistency, then your patient may have an infection.

@@GeorgeORRT The color ranges from clear to brownish and sometimes very thick, especially in the mornings. No fever present. Oral care 2x day with yankauer in mouth to reduce swallowing of mouthwash/secretions. I would make suctioning more frequent, but I feel it may be counterproductive since patient tends to secrete more during suctioning. Is there any specific brand of oral wash to use for oral care? The dentrifice on the swabs is almost nonexistent.

@@paranoidhumanoid Hi: Is this a new colour change when suctioning or is it chronic? You would expect it to be thicker in the morning as tracheal suctioning may be diminished during the evening to allow the patient to rest. Sounds like your diligent with your suctioning. Never suction a patient unless they need it. PRN is better than routine Q2H suctioning. If secretions are brown and occur as tracheal suction is performed during the day, could be a sign of a small laceration or ulceration in the mucosa that has resulted in a minor bleed. Regarding oral care products, check to see whats available in your hospital and change it up if protocols allow. Also check with the attending doc to see what they may suggest for oral care rinses.

@@GeorgeORRT Thanks for sharing your knowledge! The secretions in the canister varies from clear to yellow. But when patient coughs out a wad of phlegm, and it sits out for a bit (while I'm away), it turns brown and is odorous and begins to congeal almost. There is some blood around the stoma which appears on the drainage sponge, but I have not observed any in the secretions except for once earlier on when I inadvertently pushed the catheter down the trach too hard (it stopped bleeding within minutes). Patient is due for a trach change (it's been over a month past the due date) but there were supplies issues that caused the delay. I wish pulmonary specialists could do home visits, but because of COVID it's unlikely. As for oral care -- I use Colgate alcohol free fluoride rinse or Colgate Zero and xylitol to keep oral bacteria at bay and I squeeze out the excess from the swab before oral care. I floss once a week using rubber pick and ultrasonic brush if plaque is present. The swabs I have appear to have dentrifice on it, but there's barely anything on it when water is applied. (BTW I'm not an RN, I nurse a family member who is vegetative).

Hi: How long has the patient been trached?@@paranoidhumanoid

Corrected