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Tracheal suction catheter, closed system, each

HCPCS code

Name of the Procedure:

Tracheal Suction Catheter, Closed System (HCPCS Code: A4605)


A tracheal suction catheter system is a medical device used to clear secretions from the patient's airway. The closed system is designed to minimize the risk of infection and to provide a consistent and effective method for respiratory care for patients who cannot clear their own throat or lungs.


  • Medical Conditions: Primarily used for patients with tracheostomy or endotracheal tubes, and those unable to clear secretions due to conditions such as chronic obstructive pulmonary disease (COPD), pneumonia, or neurological impairments.
  • Goals: The primary goal is to maintain a clear airway, prevent respiratory infections, improve oxygenation, and enhance overall respiratory function.


  • Excessive mucus production or inability to clear mucus
  • Presence of atelectasis (collapsed lung portions) due to mucus blockage
  • Respiratory distress or difficulty breathing related to secretion buildup
  • Patients with tracheostomy or on mechanical ventilation


  • Pre-Procedure Instructions: No specific fasting is required. Patients may need to adjust medications as advised by their healthcare provider.
  • Diagnostic Tests: Routine respiratory assessments, such as pulse oximetry or arterial blood gas analysis, may be performed prior to the procedure.

Procedure Description

  1. Setup: Ensure all equipment, including the closed suction catheter, is sterilized and ready for use.
  2. Positioning: Patient is positioned to ensure easy access to the tracheostomy or endotracheal tube.
  3. Connection: The closed catheter system is connected to the ventilator circuit or the tracheostomy tube.
  4. Suctioning: The catheter is inserted through the airway tube and suctioned while pulling back to remove secretions. This process can be repeated as necessary.
  5. Completion: The catheter is retracted into the closed system to ensure it remains sterile for future use.

Tools: Closed suction catheter system, suction unit. Anesthesia: Not typically required, but patient comfort measures such as sedation may be provided based on individual needs.


The procedure generally takes a few minutes but may be repeated several times a day as needed.


The procedure is usually performed in a hospital, intensive care unit (ICU), or outpatient clinic setting.


  • Respiratory therapists
  • Nurses
  • Physicians or advanced practice providers
  • Technicians to handle machinery

Risks and Complications

  • Common Risks: Minor bleeding, temporary discomfort, short-term coughing.
  • Rare Risks: Infection, hypoxia (low oxygen levels), mucosal damage, bronchospasm. Each risk is managed through monitoring and appropriate interventions by healthcare staff.


  • Expected Benefits: Improved airway patency, decreased risk of respiratory infections, better oxygenation and overall respiratory function.
  • Timeline: Benefits are typically realized immediately after secretions are cleared.


  • Post-Procedure Care: Routine monitoring of respiratory status. Hydration and humidification may be increased to help keep secretions thin.
  • Recovery Time: Recovery is near-immediate; any discomfort generally subsides quickly.
  • Restrictions: Minimal, with normal respiratory care resumed.
  • Follow-Up: Regular assessments to determine the need for repeated suctioning.


  • Other Options: Manual suctioning with open catheter systems, chest physiotherapy, mechanical ventilation adjustments, mucolytic medications.
  • Pros and Cons: Manual suctioning has a higher risk of infection and may be less effective. Chest physiotherapy is non-invasive but less efficient for immediate secretion clearance.

Patient Experience

  • During: Patients may experience brief discomfort, coughing, or a choking sensation.
  • After: Improved breathing ease and reduction in distress. Discomfort generally resolves quickly.
  • Pain Management: While the procedure is usually not painful, patient comfort is a priority. Sedation or pain relief measures are provided as necessary to ensure a comfortable experience.

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