What a home suction machine does and when you need one
A home suction machine removes mucus and secretions from the airway through a tracheostomy tube or through the mouth and nose. If you or a family member has a tracheostomy (a surgically created opening in the windpipe), or if thick secretions build up and cannot be coughed out naturally, suctioning keeps the airway clear so breathing stays easier and safer.
Your doctor or respiratory therapist will tell you whether suctioning is needed at home. They will also show you the specific steps for your situation, because technique varies depending on whether you are suctioning through a tracheostomy tube, through the nose, or through the mouth. This guide explains the general process and safety steps so you understand what to expect and what to watch for.
Key Takeaways
- A home suction machine has a motor unit, tubing, and a suction catheter (the thin tube that enters the airway), and your respiratory therapist will show you which size catheter and which pressure setting to use.
- Always wash your hands before suctioning, use clean or sterile catheters depending on what your doctor ordered, and never reuse a catheter after it has touched the airway.
- Suctioning should take no more than 10 to 15 seconds at a time, and you should wait at least 30 seconds between attempts to let the person breathe normally and their oxygen level recover.
- Signs that suctioning is working include easier breathing, clearer breath sounds, and less rattling in the chest; signs of a problem include bleeding, difficulty breathing that does not improve, or a fever that develops after suctioning.
- Your respiratory therapist or home health nurse will visit to teach you the technique, check your equipment, and answer questions about when to suction and when to call the doctor.
The parts of a home suction machine and how to set it up
A typical home suction machine has three main parts: a motor unit (the box that creates the suction), tubing that connects to the motor, and a suction catheter (a thin flexible tube that goes into the airway). The motor unit usually plugs into a wall outlet, though portable battery-powered models exist for people who travel or need suctioning away from home.
Before you use the machine for the first time, your respiratory therapist will show you how to assemble the tubing and catheter, how to set the suction pressure (measured in millimeters of mercury, or mmHg), and how to test that suction is working. The pressure setting is important—too low and secretions will not clear; too high and you risk damaging the airway lining. Your therapist will write down the correct pressure for your situation. Most adults use between 80 and 150 mmHg; children use lower pressures.
Keep the machine in a clean, dry place. Store catheters in their sterile packaging until you are ready to use them. If you use clean (not sterile) catheters, store them in a clean container and replace them according to your therapist's instructions—usually every 24 hours or when visibly soiled.
Step-by-step suctioning technique
Before you start, wash your hands with soap and water for at least 20 seconds. Gather your supplies: the suction machine, a clean or sterile catheter in its packaging, a cup of clean water or saline solution, and clean gloves if your doctor recommended them.
Turn on the machine and test the suction by placing your thumb over the end of the tubing—you should feel a strong pull. Then follow these steps in order:
- Open the catheter package and attach it to the tubing without touching the part that will enter the airway.
- Tell the person you are about to suction, or if they cannot communicate, position them so they are sitting upright or lying on their side (not flat on their back).
- Gently insert the catheter into the tracheostomy tube, nose, or mouth without applying suction yet. Insert only as far as you can see or as far as your therapist instructed.
- Apply suction by covering the suction port (usually a small hole on the side of the catheter) with your thumb, and slowly withdraw the catheter while rotating it gently. This should take no more than 10 to 15 seconds.
- Remove the catheter and turn off the suction.
- Rinse the catheter by applying suction to a cup of clean water or saline to flush out secretions. Then throw away the catheter.
- Wait at least 30 seconds before suctioning again. During this time, the person should breathe normally and their oxygen level should recover.
If secretions are very thick, your therapist may recommend instilling a small amount of saline solution into the airway before suctioning to help loosen secretions. Only do this if your doctor or therapist has specifically instructed you to do so.
Signs that suctioning is working and when to stop
After suctioning, you should notice that breathing sounds clearer, the person breathes more easily, and any rattling or gurgling sound in the chest decreases. These are signs the airway is clearer. You may also see secretions in the catheter—the color and thickness can tell you something about what is happening. Clear or white secretions are normal; yellow or green may suggest infection; blood-tinged secretions need to be reported to your doctor.
Stop suctioning when the airway sounds clear and breathing is easier. You do not need to suction repeatedly until nothing comes out—that can irritate the airway. Most people need suctioning a few times a day, though some need it more often if they have a respiratory infection or are producing extra mucus. Your therapist will help you figure out a schedule based on the person's needs.
If the person's breathing does not improve after one or two suctioning attempts, or if they seem to be getting worse, stop and call your doctor or respiratory therapist. Do not keep suctioning in hopes it will help—that can cause harm.
Cleaning and maintaining your suction machine
After each use, rinse the tubing by running clean water or saline through it while applying suction. This prevents secretions from drying inside the tube and blocking it. Once a week, or more often if secretions are thick, disconnect the tubing and soak it in a mixture of equal parts white vinegar and water for 30 minutes, then rinse thoroughly with clean water and hang it to dry.
Check the machine's filter regularly—your manual will tell you how often. A clogged filter reduces suction power. If suction feels weaker than usual, check the filter first. Most filters can be rinsed under running water; some need to be replaced. Keep replacement filters on hand.
Store the machine in a cool, dry place away from direct sunlight. If you travel, use a portable suction machine or ask your equipment company about travel options. Never leave the machine in a hot car or expose it to extreme temperatures, as this can damage the motor.
When to call your doctor or respiratory therapist
Contact your doctor or respiratory therapist right away if you notice blood in the secretions, if the person has difficulty breathing that does not improve after suctioning, if there is a foul smell to the secretions, or if the person develops a fever. These can be signs of infection, airway injury, or other problems that need medical attention.
Also call if the suction machine stops working, if you are unsure whether suctioning is helping, or if the person is coughing up more secretions than usual. Your therapist can adjust your technique, change the pressure setting, or recommend other treatments. Do not assume that more frequent suctioning is always the answer—sometimes it means something else is going on that needs to be addressed.
If the person has a tracheostomy and suddenly cannot breathe through it, this is an emergency. Call 911. Do not try to suction if the tube appears blocked—the blockage may be inside the tube itself, and suctioning might make it worse. Emergency responders are trained to handle this situation.
Frequently Asked Questions
How do I know if my suction machine pressure is set correctly?
Your respiratory therapist will set the pressure and write it down for you. You can check it by looking at the gauge on the machine. If suction feels too weak and secretions are not clearing, or if the person coughs a lot during suctioning, tell your therapist—the pressure may need adjustment. Never change the setting on your own without guidance.
Can I reuse a suction catheter if I rinse it?
No. Once a catheter has touched the airway, throw it away after that use. Reusing catheters increases the risk of infection. Your doctor will tell you whether to use sterile or clean catheters at home, but either way, each catheter is single-use only. Your equipment company can deliver catheters regularly so you always have a supply.
What if the person gags or coughs during suctioning?
Gagging and coughing are normal reflexes. Stop suctioning, let them cough, and wait 30 seconds before trying again. If coughing is severe or does not stop, wait longer before the next attempt. If the person coughs up secretions on their own, that is actually helpful—it means the airway is clearing naturally. You may not need to suction as often.
Is it normal for suctioning to hurt?
Mild discomfort or a tickling sensation is normal, but suctioning should not be painful. If the person says it hurts, you may be inserting the catheter too far, using pressure that is too high, or suctioning for too long. Stop and contact your therapist to review your technique. Pain can also mean the airway lining is irritated or injured, which needs medical attention.
How often should I suction?
There is no fixed schedule—it depends on how much mucus the person is producing. Some people need suctioning every few hours; others need it only once or twice a day. Your therapist will help you establish a routine based on listening to breath sounds and watching for signs that secretions are building up. If the person starts producing more mucus than usual, that can be a sign of infection or other illness and should be reported to your doctor.