Preparing for the endotracheal suction

procedure
A sterile tray containing :
1. Laryngoscope
2. Ambu bag and mask
3. ETT
4. Tegaderm
5. Scissors
6. Suction device with connected tubing
7. Standard suction catheter
8. Normal saline or sterile water for clearing
tubing
9. 2 ml syringe
10. Sterile gloves and mask
A clean tray containing :
11. Dry cotton gauze in bowl
12. Kidney tray and a paper bag
13. Pulse oximeter
14. Stethoscope
15. a) Identifies client.
b) Identifies indications for suctioning.
c) Provides privacy.
16. Explains procedure to family members/
relatives, if significant.
17. a) Uses standard precautions (i.e wearing
gown and goggles).
b) Washes hands.
18 . Assembles necessary equipments.
19. Checks the proper functioning of
equipments.
Steps of performing endotracheal suction
Safety
1. Maintains dexterity.
2. Prepares to maintain airway and initiate
resuscitation measures.
Prepares for suctioning:
3. Places the patient in supine position with
head slightly extended.
4. Places the patient on pulse oximeter to
assess oxygenation.)
5. Hyperoxygenates for 30-60 seconds
before suctioning.
6. Checks the suction levels as follows:
60-80 mmHg for infants,
80-100 mmHg for under 1012 years,
100120 mm Hg for older children.
7. Open and prepares suction catheter and
normal saline container maintaining clean

technique.
8. If using saline instillation prior to
suctioning, draw up 0.25 - 0.5 ml into 2 ml
syringe)
9. Washes hands in sterile manner.
10. Puts on mask.
11. Glove both hands.
12. Disconnects the ventilator and instill NS
into ETT.
13. Reconnects the patient to the ventilator
and allow 5 breaths to be delivered.
14. Removes the suction catheter from the
package and attach it to the suction tubing.
15. Checks the suction pressure once the
suction catheter is connected.
16. Disconnects the ventilator tubing from
patient's ETT.
17. Inserts the suction catheter down the
ETT to the predetermined length
i.e length of ETT at lip margin minus 0.5 cm.
18. Makes sure not to apply suction while
inserting the suction catheter.
19. Applies continuous suction by covering
the suction control hole.
20. Removes catheter in rotating movement.
21. The single episode of suctioning from
removing of ventilator to reattachment
of ventilator should not exceed 10-15
seconds.
22. Monitors O2 saturation level of patient
between each episode of suctioning.
23. Wipes the catheter and suction tubing
and flush it with normal saline until clear
24. Hyperoxygenates the client for at least 1
min, then gradually decrease oxygen
to the level prior to suctioning, as tolerated
by the patient.
Oral Suctioning :
25. Uses a padded tongue blade to depress
the tongue and slides catheter along one
side until it reaches the back of the mouth.
26. Suctions cheeks, beneath the tongue,
back of the mouth or oropharynx as needed.
Nasal Suctioning :
27. Inserts catheter slight downward and
slant through one nostril along the floor)
of the nasal cavity and suctions the nasal
cavity.

28. Observes color, quantity and type of

secretions.
29. Reassess patient's respiratory status.
Steps of terminating procedure of
endotracheal suction
1. Discards used supplies as per procedure.
Documents the following :
2. Size of the suction catheter used.
3. Suction pressure applied.
4. Type of secretions recovered following the
procedure ( thick or thin ).
5. Amount of secretions recovered following
the procedure(. ml). ]
6. Color and Characteristics of secretions
recovered following the procedure. (White,
Pink, Red, Yellow, Brown or Green).
7. Recommendations for additional ventilator
settings, FiO2, flow rate etc.