SUCTIONING

PURPOSES OF ENDOTRACHEAL OR TRACHEOSTOMY TUBE SUCTIONING

O To maintain a patent airway and prevent airway obstruction

O To promote optimal respiratory exchange of oxygen and carbon dioxide into and out of
the lungs
O To prevent pneumonia that may result from accumulated secretions
Special Considerations:

Discontinue suction immediately if any of the following adverse reaction occur ;

a. Hypoxia
b. Cardiac arrhythmias
c. Hypotension and hypertension
d. Mucosal trauma
e. Laryngospasm and bronchospasm
f. Cardiac/respiratory arrest
g. Extreme anxiety or agitation

Sterile Tracheobronchial Suctioning: Equipments

a. Sterile suction catheter
b. Sterile gloves
c. Sterile Towel
d. Suction source
e. Normal saline/ irrigating solution
f. Sterile cups
g. Face shield

PROCEDURE

O Preparatory phase:

1. Monitor heart rate and auscultate breath sounds. Establish a baseline data of vital signs
and arterial blood gas
2. Explain the procedure to the client before beginning and offer reassurance during
suctioning
O Performance phase:

1. Assemble equipment. Check the function of suction and manual resuscitation bag
connected to 100% O2 source. Put on face shield.
2. Wash hands thoroughly.
3. Open suction catheter kit.
4. Fill basin with nss irrigating solution
5. Ventilate the patient with manual resuscitation bag and high-flow oxygen.
6. Put on sterile gloves. Designate one hand as contaminated for disconnecting, bagging
and working the suction control. Usually the dominant hand is kept sterile.
7. Pick up suction catheter with your dominant hand and connect to suction machine.
8. Using the contaminated hand, disconnect the patient from the ventilator, CPAP device
or other oxygen source.
9. Instill normal saline solution into airway ONLY if there are thick, tenacious secretions.
10. Gently insert suction catheter as far as the end of the tube without applying suction, just
far enough to stimulate the cough reflex.
11. Apply suction while withdrawing the catheter and gently rotating the catheter 360
degree ( no longer than 10-15 seconds )
12. Bag patient between suction passes with approximately four to five manual ventilations.
13. Repeat previous three steps until the airway is clear.
14. Return the patient to the ventilator or apply CPAP or other oxygen-delivery device.
15. Rinse catheter in sterile cups/glass with sterile normal saline solution between suction
attempts.
16. Suction oropharyngeal cavity after completing tracheal suctioning.
17. Rinse suction tubing.
18. Discard catheter and gloves appropriately.
O Follow-up phase:
1. Note change in vital signs or patient’s intolerance to the procedure. Record the amount
and consistency of secretions.
2. Assess need for further suctioning at least every 2 hours.
3. Teach caregivers to suction in the home situation using clean technique.