Airway Suctioning
Outlines
1- Definition of suctioning .
2- Sites for suction .
3- Deferent between oropharengyeal /
  nasopharyngeal suctioning and
  endotracheal / tracheostomy suctioning .
4- Purposes for suctioning .
5- Indications for suctioning.
6- Choosing the right size catheter.
Outlines Cont’
7- Setting the correct pressure .
8- The procedure .
9- Documentation.
10- Complications of suctioning .
11- Techniques to minimize or decrease the
  complications .
           Suctioning
           Definition
Aspirating secretion through a catheter
connected to a suction machine or wall
            suction outlet.
Nasopharyngeal         Oropharyngeal
          Sites for Suctioning
 Endotracheal.
                       Tracheostomy
        Deferent between Oropharyngeal
  /Nasopharyngeal suctioning and Endotracheal/
           tracheostomy suctioning
  Oropharyngeal            Endotracheal/Tracheostomy
 /Nasopharyngeal                  suctioning
    suctioning
Remove secretion from       Remove secretion from the trachea
the upper respiratory tract and bronchi or the lower respiratory
.                           tract .
                 P
                 U      Tracheal/
Oral / Nasal     R    Endotracheal
 suction         P
                 O       suction
 1- maintain     S
                 E        Remove
  oral/ nasal
                 S      pulmonary
   hygiene.      of
                       secretions in
2- comfort for   S
                 u     patients who
 the patient.
                 C     are unable to
  3- remove      T
                      cough and clear
  blood and       I
                 O       their own
 vomit in an
                 N      secretions
 emergency        I
                        effectively.
  situation.     N
                 G
            Indications
 Oropharyngeal and
  Nasopharyngeal suctioning
  required for:
1- Patient who has undergone head and
  neck surgery.
2- Signs of respiratory distress .
3- Evidence of unable to cough up and
  expectorate secreations .
             Indications Cont’
5- Obtain sample of secretion for diagnostic
  purposes
6- Prevent infection.
 Tracheal suctioning required for :
1- Patients unable to clear their secretions
  themselves.
2- patients with mechanical ventilation.
         Choosing the Right Size
               Catheter
                             Size
        Adult             #12 to #18
       Children           #8 to # 10
        Infant            # 5 to #8
• Half the diameter (or less) of the tracheal
tube.
           Choosing the Right Size
              Catheter Cont’
 Tow types of suctioning catheter :
1- Whistle – tipped catheter .
2- Open – tipped catheter .
    whistle – tipped         open – tipped catheter
       catheter
  Less irritate the airway   More effective for removing
                                thick mucus plugs .
          Setting the Correct
               Pressure
             Wall Unit       Portable Unite
Adult    100to 120 mm Hg .   10 to 15 mm Hg
Child    95 to 110 mm Hg .   5 to 10 mm Hg
Infant   50 to 95 mm Hg .     2 to 5 mm Hg
             The
          procedure
E
Q   1- Towel or moisture – resistant pad .
U   2- Portable or wall suctioning
I   machine with tubing and collection
P   receptor.
M   3- sterile deposable container for
E   fluids .
N   4- Sterile normal saline or water.
T
    The procedure Cont’
E
Q   5- Sterile gloves .
U   6- Goggles or face shield .
I   7- Sterile Suction Catheter kit .
P   8- Water – soluble lubricant .
M   10- sterile gauzes.
E   11- Moisture resistant disposable bag.
N   12- Sputum trap .
T
           The procedure Cont’
 4- position the patient.
  Conscious patient          Unconscious patient
Semi – Fowler’s position Lateral position and the
with:                    patient facing you .
✓head turned to one side
for oral suctioning .
✓For nasal suctioning
with the neck
hyperextended.
          The procedure Cont’
5- prepare the equipment .
6- make approximate measure of the depth
  for the insertion of the catheter and test the
  equipment .
7- lubricate and introduce the catheter :
The procedure Cont’
▪ For Oropharyngeal
suctioning :
    ✓Pull the tongue
    forward .
    ✓Do not apply suction
    during insertion .
    ✓Advance the
    catheter about 10 to 15
    cm along on side of
    the mouth into
    oropharynx.
The procedure Cont’
▪ For Nasopharyngeal
suction
  ✓Advance the
  catheter along the
  nasal cavity with out
  suctioning.
  ✓ Never force the
  catheter against an
  obstruction .
           The procedure Cont’
8- Perform suctioning .
9- clean the catheter and apply suction again :
      ✓Wipe off the catheter with sterile
      gauze.
      ✓Flash the catheter with sterile water or
      saline.
      ✓Relubricate the catheter and repeat
      suctioning until the air passage is clear.
    The procedure Cont’
✓Allow 20 t0 30 second intervals
between each suction and limit
suctioning to 5 minutes in total .
✓Alternate nares for repeat suctioning.
✓Encourage the client to breath deeply
and to cough between suctioning .
          The procedure Cont’
10 – Obtain specimen if required.
11- promote the patient comfort .
12- Dispose of equipment and ensure
  availability for the next suction .
13- Assess the effectiveness of suctioning .
          The procedure Cont’
11- promote the patient comfort .
12- Dispose of equipment and ensure
  availability for the next suction .
13- Assess the effectiveness of suctioning .
           Documentation
                     ➢The amount .
                     ➢Consistency .
• Record the         ➢Color .
procedure :          ➢Odor of the mucus .
                     ➢Client breathing status
                     before and after.
• If the technique is carried out frequently it
may be appropriate to record only once , how
ever the frequency of suctioning must be
record
Hypoxemia                    Trauma to
                             the airway
             Complications
                               Cardiac
Nosocomial
                             dysrhythmia
 infection
Techniques to Minimize or Decrease
the Complications
1- Suction only as needed .
2- sterile technique .
3- Hyperinflation .
4- Hyperoxygenation .
5- safe catheter size .
6- No saline instillation.
Thank you for your
    listening