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Published by Pia Korina Codilla

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Published by: Pia Korina Codilla on Dec 14, 2010
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– A method of removing excessive secretions from the airways. It may be applied to the oral, nasal or tracheal passages, using a sterile catheter

Purpose: 1. 2. 3. 4. Maintain patent airway through removal of secretions Promote adequate exchange of oxygen and carbon dioxide Substitute for effective coughing Obtain specimen for analysis

Indication: 1. When secretion can be seen or sounds resulting from secretion are heard with or without use of stethoscope (i.e moist, noisy, respiration) 2. Following postural drainage or chest physiotherapy 3. Following respiratory treatment, aimed at liquefying secretion 4. Following a sudden rise of the peak airway pressure in mechanically ventilated patients that is not due to: a. Kinking of the artificial airways b. Biting of the tube c. Patient coughing or struggling against ventilator d. Pneumothorax

fr: 14-16 Pedia – fr: 8-10 Sterile NSS for instilling Sterile water for rinsing Soluble lubricated jelly pm padded tongue depressor sterile gloves tissue papers acetic acid source of oxygen support ready to use pick-up forces Process: RATIONALE 1. test suction system and regulate pressure if indicated implementation Recommended pressure established 4. do chest/back tapping before suctioning 2. Carefully remove the catheter from its package using the dominant Appropriate position observed Need for suctioning established phlegm loosened . Explain procedure to patient and SO Cooperation and reassurance 3. Assess the need for suctioning planning 2. Positioning patient properly a.Equipment: Suctioning equipment Working suction apparatus Connections tube Sterile catheter Adult . Assemble sunctioning equipment. Conscious – semi-fowler’s b. Unconscious – supine 1. Workability and safely turn vacuum on. Auscultate for crackles.

Have NSS in syringe ready for instillation at all times b. introduce the catheter along the floor of nares until the marked area is reached 4. If obstruction is encountered do not force but remove/ insert at another angel or try other nostrils 5. and while leaving the vent open. release vent to stop suction Any obstruction determined. Dip catheter tip to sterile water 4. hold it near the vent and operate suction machine with the free hand. Put on gloves 3. Measure with catheter the distance from tip of nose to tragus of ear without touching the skin. Injury to mucus prevented Proper distance for catheter insertion determined tip lubricated properly . apply lubricant jelly to tip if necessary 3. Occlude vent with thumb and slowly withdraw catheter while rotating it in between the thumb and finger.hand. Remove needle from syringe with NSS and inject content to airway NASAL ROUTE: RATIONALE 1. patency of system tested Safety from accidental loss of needle into trachea and from aspiration airway if secretions are tenacious: a. If catheter grabs. Elevate tip of nose. Rotate catheter while in the nose. Intended for rising and allow some Tip lubrication . Apply intermittent suction. Steps 2-7 2.

Administer oxygen PRN in between aspiration 8. DO NOT SUCTION longer than 15 seconds at a time and allow 1-3 mins. then re-insert as needed 9. of necessary.6. Assess effectiveness by observing respiration and auscultating the lunhs 11. keep patient dry and comfortable 10. Wipe nose. Instruct patient to protrude tongue and guide catheter to oropharynx. Dip catheter in and out of sterile water reservoir. If necessary use padded tongue depressor to separate upper from . Step 2-7 2. Record significant observations Patient ventilated Secretions removed from catheter tubings Patient’s comfort Re-evaluation Proper documentation ORAL ROUTE: RATIONALE 1. drawing some water through it. rest in between each period unless abundance of secretions make this impossible 7. keep tongue out of the way by padded tongue depressor • Introduce catheter during inspiration Catheter insertion facilitated Over stimulation of gag reflex facilitated Biting of catheter prevented 1.

from prolonged suctioning Bleeding in patients with history of nanopharyngeal bleeding Further rise in intracranial pressure. Give mouth care.lower teeth 2. consistency and odor of secretion Complication & action taken Patient’s tolerance of procedure COMPLICATIONS OF TRACHEAL SUCTIONING: • • • • • Hypoxemia and dyspnea from removal of oxygen along with secretion Altered respiratory pattern from anxiety Tracheal or bronchial trauma. color. Proceed with steps 10-11 in nasal catheter Hygiene and comfort DOCUMENTATION: • • • • • Date and time of procedure Reason for suctioning Amount. in patients with increased ICP . Proceed with steps 5-8 in nasal route 3. make patient comfortable 4.

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