Suctioning

Prepared by: Wahida Panambola

Suctioning
Aspirating secretion through a catheter connected to a suction machine or wall suction outlet. Even though the upper airways (the oropharynx and nasopharynx) are not sterile, sterile technique is recommended for all suctioning to avoid introducing pathogens into the airway.

Suction Catheter may be either open tipped or whistle tipped. The whistle-tipped catheter is less irritating to respiratory tissue, although the open tipped catheter may be more effective for removing thick mucous plugs. An oral suction tube is use to suction the oral cavity. Most suction catheter have thumb port on the side to control the suction. The catheter is connected to suction tubing, which in turn is connected to a collection chamber and suction control gauge. Oral and Oropharyngeal suctioning removes secretion from the upper respiratory tract. Nasopharyngeal suctioning provide closer acces to the trachea and requires sterile technique.

Indication: Dyspnea

Complictions: hypoxemia

bubbling or rattling breath sounds

cyanosis decrease oxygen saturation level

trauma to the airway

nosocomial infection

cardiac dysrhythmia

To prevent complications Hyperinflation- this involve giving the client breath that are 1 to 1.5 times the tidal volume set on the ventilator through the ventilator circuit or via manual resuscitation bag. Three to five breaths are delivered before and after each pass of the suction catheter. Hyperoxygenatation- this can be done with a manual resuscitation bag or through the ventilator and is performed by increasing the oxygen flow before suctioning and between suctioning attempts.

Purpose: To remove secretion that obstruct the airway to facilitate ventilation To obtain secretions for diagnostic purposes To prevent infection that may result accumulated secretions

from

Equipments: towel or moisture-resistant pad portable or wall suction machine with tubing, collection receptacle, and suction pressure gauge sterile disposable container for fluid sterile normal saline or water sputum trap, if specimen is to be collected suction catheter tip sterile gloves y-connector

Performance: Explain the client about the procedure performed hand hygiene prepare the client Position a concious pt. who has function gag reflex in semi-high fowlers position with the head turned to one side for oral suctioning or with the neck hyperextended for nasal suctioning Position an unconscious client in the lateral position, facing you. place the towel over the pillow or under the chin Prepare the equipment set the pressure on the suction gauge, and turn on the suction. Many suction device are calibrated to three pressure ranges Wall unit a. adult: 100 to 120 mm hg b. child 95 to 110 mm hg c. infant: 50 to 95 mm hg Portable unit a. adult: 10 to 15 mm hg b. child: 5 to 10 mm hg c. infant 2 to 5 mm hg

For Oral Suctioning 1.Moisten the tip of the suction catheter with sterile water or saline 2.Pull the tounge forward, if necessary, using gauze 3.Do not apply suction during insertion 4.Advance the catheter about 10 to 15 cm along one side of the mouth into the oropharynx

For Nasal Suctioning 1.Open the sterile suction package a.Set up the cup or container, touching only the outside b.Pour sterile water or saline into the container c.Put on the sterile gloves, or put on a nonsterile glove on the nondominant hand and then sterile glove on the dominant hand 2.With your sterile gloved hand, pick up the catheter and attached to the suction unit

3. Make an appropriate measure on the depth for the insertion of the catheter and test the equipment a.Measure the distance between the tip of the clients nose and the earlobe, or about 13 cm for adult b.Mark the position of the tube with the finger of the sterile hand c.Test the pressure of the suction and the patency of the catheter by applying your sterile gloved finger or thumb to the port or open branch of the Y-connector to create suction 4. Lubricate and introduce the catheter a.Lubricate the catheter tip with sterile water, saline, or water soluble lubricant b.remove oxygen with the nondominant hand, if appropriate c.without applying suction, insert the catheter the premeasured or recommended distance into either naris and advance it along the floor of the nasal cavity d.Never force the catheter against the obstruction. If one nostril is obstructed, try the other

5. Perform suctioning a.Apply your finger to the suction control port to start suction, and gently rotate the catheter b.Apply suction for 5 to 10 seconds. During this time, then remove your finger from the control and remove the catheter c.A suction attempt should last only 10 to 15 seconds. During this time, the catheter is inserted, the suction is applied and discontinued, and the catheter is removed 6. Rinse the catheter and repeat suctioning as above a.Rinse and flush the catheter and tubing with sterile water or saline b.Relubricate the catheter, and repeat suctioning until the air passage is clear c.Allow sufficient time between each suction for ventilation and oxygenation. Limit suctioning to 5 minutes in total d.Encourage the client to breath deeply and to cough between suction

7. Obtain a specimen if required a.use a sputum trap b.attach the suction catheter to the tubing of the trap c.attach the suction tubing to the sputum trap air vent d.suction the client. The sputun trap will collect the mucus during suctioning e.Remove the catheter from the client. Disconnect the sputum trap from the suction catheter. Remove the suction tubing from the trap air vent. f.Connect the tubing of the sputum trap to the air vent g.Connect the suction catheter to the tubing h.Flush the catheter to remove secretion from the tubing Post Promote client comfort a.Offer to assist the client with oral or nasal hygien b.Assist the client to a position that facilitate breathing