Sharon B.

Cajayon MAN , RN
 Define suctioning and its purpose.
 Identify clinical signs indicating need for
suctioning.
 Describe how to safely perform
oropharyngeal and nasopharyngeal
suctioning.
 Perform properly the procedure.
 Aspirating secretions through a
catheter connected to a suction
machine or wall suction outlet
 Upper airway suctioning:
◦ Oropharyngeal suctioning
◦ Nasopharyngeal suctioning
Wall mounted machine Portable suction machine
 To remove secretions that obstruct the
airway
 To facilitate ventilation
 To obtain secretion for diagnostic
purposes
 To prevent infection that may result
from accumulated secretions
 Restlessness/anxiety
 Gurgling sound during
respiration
 Adventitious breath
sound
 Change in mental status
 Skin color
 Rate and pattern of
respiration
 Pulse rate and rhythm
• “Noisy breathing”
• Audible or visual signs of secretions in the
tube.
• Signs of respiratory distress.
• Suspicion of a blocked or partially blocked tube.
• Inability by the child to clear the tube by
coughing out the secretions.
• Vomiting.
• Desaturation on pulse
• oximetry.
Conduct a Risk Assessment:
• Patients with a recent head or neck
injury
• Geriatric and pediatric patients, who
have more fragile airways
• People with cognitive or mental health
conditions that make it more difficult for
them to understand the procedure and
cooperate
• Patients with loose dental hardware
• Patients with a difficult airway or a
history of suctioning complications
• Patients with bradycardia
• Patients with hypoxia
Types:
 Open tipped
 Whistle tipped
◦ Less irritating to
respiratory tissues
◦ More effective for
removing thick
mucous plugs
Yankauer tube
- Used to suction
oral cavity
- Reusable
 Adult
◦ Fr # 12 to 18
 Children
◦ Fr # 8 `to 10
 Infants
◦ Fr # 5 to 8
Suction pressure Suction pressure
 Adult  Adult
◦ 100 to 120mmHg ◦ 10 to 15mmHg
 Child  Child
◦ 95 to 110mmHg ◦ 5 to 10mmHg
 Infant  Infant
◦ 50 to 95mmHg ◦ 2 to 5mmHg
 Do not force through nares
during insertion
 Length of insertion:
◦ Oropharyngeal
 Measure from tip of the nose to angle of
mandible.
◦ Nasopharyngeal
 Adult: 16cm (5-6 inches)
 Older children: 8 to 12cm (3 to 5 inches)
 Infants and young children: 4 to 8 cm (2 to 3
inches)
 Hyperoxygenate first prior suctioning
 Suction time:
◦ Each suction: 10-15 seconds
◦ Interval or in-between suction: 30 sec- 1
min
◦ The maximum suction time should only be
15 seconds.
◦ After suctioning, re-oxygenate the patient.
◦ Whole procedure: maximum of 5 minutes
◦ Prolonged suctioning increases the risk of hypoxia and
other complications.
 OROPHARYNGEAL/
NASOPHARYNGEAL SUCTIONING
PROCEDURE
• Greet and Identify the patient
• Ask patient’s name and check pt’s id bracelet
• Determine the patient need for suctioning:
◦ audible secretions during respiration
◦ adventitious breath sounds
• Explain the procedure- to allay anxiety and tell the
importance of suctioning that tis procedure will
relieve breathing problems
• Wash hands
• Provide client’s privacy
• Check the nares (Naso)
and mouth (Oro) using penlight
• Position appropriately

Unconscious Conscious
patient patient
Lateral position Semi – Fowler’s position
and the patient with:
facing you . ühead turned to one side
-this position allows thefor oral suctioning .
tongue to fall forward, üFor nasal suctioning
not to obstruct the with the neck
catheter for insertion
and facilitates drainage
hyperextended.
of secretion üThis position facilitate the
insertion and prevent aspiration
• Prepare the materials:
• Suction tube (size), gloves, towels, gauze pad,
sterile water, goggles, emesis basin
• Set up the suction apparatus and calibrate
the pressure on the suction gauge.
- prevent trauma to mucous membrane
• Place towel/ sterile drape on the chest
 Open appropriate suction
kit or catheter using
sterile technique.
 Open sterile basin and fill
with approximately 100ml
of sterile normal saline
solution or water. Open
lubricant and squeeze
small amount onto sterile
catheter package
◦ Naso- water soluble
lubricant
◦ Oro- sterile water or NSS
 Apply gloves
◦ Oropharyngeal : clean
gloves
◦ Nasopharyngeal: sterile
gloves
 Pick up suction catheter
with dominant hand
without touching non
sterile surface.
 Pick up connecting tubing
of the suction apparatus
with non dominant hand.
And connect it to the
suction catheter.
 Place tip of catheter into
sterile basin and suction a
small amount of NSS. To
check the patency of the
tubing

 Apply suction by placing

the thumb over the
suction control
 Measure the catheter to
be inserted. Make a
mark
OROPHARYNGEAL SUCTIONING
 Remove O2 mask if present but keep it near
the patient’s face
 Insert catheter gently into patient’s mouth
 Do not apply suction during insertion- it
may cause trauma in mucus membrane
 Suction intermittently moving around the
mouth including pharynx and gum line
 Advance the catheter about 4-6 in.
 Apply suction for only 5-10 seconds
along one side of the mouth to prevent gagging
 Slowly remove the catheter in a rotational
manner
Nasopharyngeal
 Lubricate distal 6-8 cm (2-3 inches) of catheter
tip with water-soluble lubricant.
 Remove O2 device with non dominant hand while
using dominant hand insert catheter into the
nares.
 Have patient take a deep breath and gently
insert the catheter downward and advance to
pharynx.
 Apply intermittent suction 5-10 seconds
 Non- sterile finger in the suction port
 Sterile hand in the suction catheter
 Alternate nares for repeat suctioning
Oropharyngeal Nasopharyngeal
 Encourage patient to  Apply intermittent
cough and repeat suction while slowly
suctioning if needed. withdrawing catheter in
Replace O2 mask rotating between thumb
 Rinse catheter with and forefinger.
saline or water from
basin with suction
until cleared from
secretions.
 Cleans the catheter by wiping off
thick secretions with the gauze pad
or rinse catheter and connecting
tubing with normal saline or water
until cleared.
 During suction, If the patient coughs,
withdraw the catheter immediately
 Flush catheter after each suction
with sterile saline
 Assess for need to repeat suctioning
procedure.
 Ask patient to deep breath and
cough.
 LIMIT SUCTIONING TO 5 MIN
 If using yankuer catheter, place in a
clean, dry area for reuse with
suction turned off.
 Disconnect catheter from
connecting tubing.
 Turn off suction machine.
 Dispose catheter rolled inside
the used gloves and discard in
appropriate receptacle.
 Remove towel and place in
laundry or remove drape and
discard
 Reposition patient to promote
client’s comfort
 Do oral hygiene/ nasal hygiene
 Discard all soiled materials
 Evaluate patient:
 VS:RR,HR, lung sounds to
assess effectiveness of
suctioning, level of anxiety,
oxygen saturation
 Return the head of the bed
 Obtain specimen if required
(sputum trap)/gene expert
 Wash hands and Document.
COMPICATION OF
SUCTIONING :
• Hypoxia.
• Airway Trauma.
• Psychological Trauma.
• Pain.
• Bradycardia.
• Infection.
• Ineffective Suctioning may cause
STRESS
 Sample Charting

If the technique is carried out frequently it may be appropriate to

record only once , how ever the frequency of suctioning must be
recorded