SUCTIONING
Irish Camille P. Campo, RN, MSN
SUCTIONING
• is 'the mechanical aspiration of pulmonary secretions
from a patient with an artificial airway in place'. The
procedure involves patient preparation, the suctioning
event(s) and follow-up care.
TYPES OF SUCTIONING
• Nasopharyngeal Suctioning
• Oropharyngeal Suctioning
• Endotracheal Suctioning
TRACHEOSTOMY
• Is surgical procedure in which an opening is made into the
trachea.
• The indwelling tube inserted into the trachea tracheostomy
tube).
• Tracheostomy is used to bypass an upper airway obstruction, to
allow removal of tracheobronchial secretions, to permit the long
term use of mechanical ventilation, to prevent aspiration of oral
or gastric secretions in the unconscious or paralyzed patient.
ENDOTRACHEAL SUCTIONING
• Removal of secretion from the
tracheobronchial tree through an
endotracheal tube with the help of
mechanical suction device.
Purpose
• Maintain the patent airway by removing the
secretion
• Prevention of respiratory tract infection from
lodgement of secretion
Equipment
• Suction Machine
(portable or wall
mounted)
Equipment
CLEAN TRAY:
• Sterile Suction Catheter
• Normal Saline or
sterile water
• Sterile gloves
• Mask, Face shield
• Alcohol Swab
• Stethoscope
STERILE TRAY
• Sterile bowl
• Gauze pieces
Procedure
1. Assemble the equipment and check the functioning of suction
apparatus.
2. Explain the procedure to patient or his relatives.
3. Assess the base line data and respiratory status of patient i.e.
breath sound, ABG value etc.
4. Provide semi fowler’s position to patient .
5. Wear the mask and wash the hand properly.
6. Open the sterile tray. Place the catheter into sterile tray after
removing from pack
Procedure
7. Wear the sterile gloves and use the dominant hand for suction.
8. Connect suction catheter from suction unit with other hand
(clean hand).
9. Disconnect the patient from oxygen source i.e. ventilator,
CPAP, or any oxygen device.
10. Ventilate the patient from AMBU bag.
11. Lubricate the catheter with sterile water or normal saline.
12. Turn on suction unit with clean hand.
Procedure
13. Pinch the catheter and insert the catheter without force until
patient cough or as the feeling of resistance take place.
14. Apply the suction by releasing the pinch and withdraw the
catheter by gentle rotating movement.
15. Time duration for suction should not be more than 10 seconds.
16. Hyperventilate the patient in between the suction or encourage
for deep breath and coughing.
17. Rinse the catheter from sterile water until it become clear
from secretion.
Procedure
18. Repeat the procedure as needed and provide rest
between the suction.
19. When airway becomes clear connect the oxygen
delivery system to the patient.
20. Suction oral secretion from oropharynx.
21. When procedure is completed turn off the suction unit
and disconnect the suction tubing from suction catheter.
22. Remove the gloves and discard the catheter and gloves.
Procedure (After Care)
1. Replace the article, clean AMBU bag and mask with
alcohol.
2. Wash hands.
3. Provide comfortable position to the patient.
4. Auscultate the lung area.
5. Record the procedure with time and date, nature of
secretion, and respiratory sound before and after the
procedure.
OROPHARYNGEAL/NASOPHARYNGEAL
SUCTIONING
• Oropharyngeal (OPA) and nasopharangeal (NPA)suction is a
technique intended to stimulate a cough to remove excess
sputum and/or aspirate secretions from the airways that cannot
be removed from a patient’s own spontaneous effort.
• A cough may be stimulated by a catheter in the pharynx
(oropharyngeal suction) or by passing a catheter between the
vocal cords and into the trachea to stimulate a cough
(nasopharyngeal suction).
OROPHARYNGEAL/NASOPHARYNGEAL
SUCTIONING
• The trachea is accessed by insertion of a suction catheter either
via the nasal passage and pharynx (nasotracheal suction) or via
the oral cavity and pharynx (orotracheal suction) using an
airway adjunct.
• Nasotracheal suction may be undertaken directly via the nostril
without an airway adjunct. However, in some situations, where
repeated suction is anticipated and therefore a nasopharyngeal
airway should be utilized. Secretions are removed by the
application of sub-atmospheric pressure via wall mounted
suction apparatus or portable suction unit.
Procedure
1. Assemble the equipment and check the functioning of suction
apparatus.
2. Explain the procedure to patient or his relatives.
3. Assess the base line data and respiratory status of patient i.e.
breath sound, ABG value etc.
4. Provide semi fowler’s position to patient .
5. Wear the mask and wash the hand properly.
Procedure
1. Place towel or water proof pad across the patient chest.
2. Apply gloves.
3. Connect the suction catheter to suction tubing connected with
suction device.
4. Turn on the suction.
5. Remove oxygen device.
6. Insert catheter to mouth or nasal cavity move catheter in cavity
until suction are cleared.
7. Replace the mask or oxygen device. Rinse the catheter with water
until the secretion is cleared from suction tubing.
Procedure (After Care)
1. Evaluate the respiratory status.
2. Remove the towel and gloves.
3. Reposition the client in comfortable position.
4. Wash and clean the articles used in suction.
5. Replace the articles.
6. Wash hand.
7. Document the procedure, finding and condition of
patient pre and post suction.
