Suctioning - Suctioning is recommended, in addition to postural drainage:

o For an excessive accumulation of mucous in the lungs, probably due to poor

cough function
o Before breathing reeducation or glossopharyngeal breathing (GPB) instruction
to ensure clear airways
o For acute tracheostomy patients who are very susceptible to infection during
the first 8 weeks and therefore require sterile suctioning techniques
o For chronic tracheostomy using clean techniques

Patients with known bradycardia should be carefully monitored during suctioning,

since suctioning may stimulate the vagus nerve and further decrease the heart rate.
Adjunct prophylaxis with IPPB (intermittent positive pressure breathing) is
recommended for patients who continue to retain secretions and/or develop
atelectasis. Immediately following SCI, tracheal suctioning can cause a rapid fall in
heart rate and cardiac arrest, if oxygen is not administered prior to these procedures.