JAZZLE GEORGE E.
OTEYZA                                          NCMB 312 RLE
BSN 3Y1-3A                                                       LAB MODULE COURSE TASK
Tracheostomy
        means the process of making incision through the neck into the trachea which opens airway and
helps in the breathing. Tracheostomy suctioning means it removes the thick mucus and secretions from the
Trachea and lower airway when patient is not able to clear their throats by coughing.
     WHEN TO PERFORM                           IN WHOM                   WHEN NOT TO PERFORM
            SUCTION                                                                SUCTION
     1. Before Meals                in patients with Obstruction of   if patient is not pre oxygenated
                                    the mouth or throat               then risk of Hypoxia is high then
                                                                      remove the suction tube.
     2. Suction should be done      Breathing difficulty is caused by Do not perform suction while
        to patients when they       Edema (swelling), injury or inserting Catheter. This causes
        wake up in morning and      pulmonary (Lung) condition increases the chance of injuring
        before go to bed in         problems.                         the Mucous membrane.
        evening.
     3. in some patients, mucus     in patients who have Tracheal or Suctioning limit should not
        plugs    or     increased   Laryngeal surgery                increase the 10 seconds.
        sputum production may
        cause     decrease     in
        Oxygen levels and then
        Suctioning should be
        done.
     4. when sputum sample is       Due to swallowing problem in if patient develop cardiovascular
        required but patient is     patients have airway protection changes like cardiac arrythmia
        unable to cough to          from secretions or food.        then suction is risk
        provide enough sample
        then Suctioning helps to
        obtain sample.
     5. Visible     or    audibleIn patients who have head or           if infection developed due to
        secretions in the airway neck surgery they need airway          suction then immediately stop
                                 protection and need suctioning         suction
     6. Oxygen desaturation and in patient who need long term           if patient feels discomfort and
        restlessness of patient ventilator support                      injury to the Tracheal mucosa
        then suctioning should                                          then suction is risk.
        be done.
     7. signs of Respiratory in Respiratory failure patients            Endotracheal suction should not
        distress like increased due to cardiac or respiratory           perform routinely but only when
        Respiratory        rate, diseases                               mucus secretions are present.
        Tachycardia, gasping,
    difficulty breathing then
    suctioning should be
    done.
8. Suspected          Airway     defects in Neuromuscular system installation of normal saline
    obstruction in patient       that controls breathing, injury to before the Endotracheal suction
    suctioning should be         chest patients                     should not be performed
    done                                                            routinely.
9. increased       resistance,   patients with Artificial airway Patients who are not intubated
    decreased          SPO2,     require suctioning while they are and have Coarse breath sounds
    increased PEEP and           on ventilator.                     then     the  patient    should
    increasing Fio2 are signs                                       encourage to cough before
    that     indicate     that                                      suction.
    suctioning must be done
    in Intubated patient.
10. Endotracheal suctioning      Acute respiratory distress        complications like Atelectasis
    should be done when                                            and hemorrhage then suctioning
    patient shows Sawtooth                                         is risk.
    pattern on flow volume
    loop     on     ventilator
    monitor.
                       Nursing Intervention: Suctioning and Tracheostomy Care
        In our online class, it is good to see such procedures and eventually learn it through the new normal.
Our institution really provides us the knowledge we need even though there is a pandemic crisis. I watched
videos regarding tracheostomy care and suctioning and closed suction systems. I was amazed by the
animation and knowledge brought by the videos. Even though there is a barrier between physical class and
for nursing students, we can find ways on how to learn such procedures. The first video I watched is about
tracheostomy care and suctioning. It was about a demo tackling a nursing intervention which is specifically
about tracheostomy care and suctioning. The video is very specific on what should we do. From the entry
to the patient’s room up to the end procedure. There is a specific part of the procedure that I took on very
well. 50% saline into the large compartment and other 50% to 2 compartments which is 25 and 25 plus with
hydrogen peroxide. We need to take in mid specific information like this and as a nurse it is important to
take note and it will be helpful for my future procedure as we go on with our duty. Before proceeding to
suctioning, I also take note that there is a different purpose of our both hands. Dominant hand should always
be sterile and other hand is clean. This will be proven helpful in the suctioning process. Suctioning and
tracheostomy care is very complex and quite hard to understand. But will the help of these videos and the
practical knowledge of our clinical instructors. I was enabled to learn such things even without actually
seeing it physically. I wish I could see the actual way but I with these kinds of videos I have a head start.
        The 2nd video is about using Intersurgical’s Trach seal, closed suction systems. It is a video about
a comprehensive guide on setting up and using trachseal close suction system. As I search pictures about
these and what I’ve seen on videos, this is the usual thing that I watch on movies whenever a patient is
hospitalized. There is a tube-like that is inserted on a patient’s mouth. Usually for patient who are
unconscious. At first, I was like, I saw this procedure before and I knew it, it is the usual thing I’ve seen on
movies. I’m glad I took nursing as a college degree. I have come to realize that nursing is really a fun and
practical thing to do as nursing encompasses many things in life. I hope I can have the duty soon, so that I
can apply what I have learned in online class.