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material from the trachea and nasopharyngeal area that cannot be removed by the patient's spontaneous cough or other less invasive procedures. This has been used to maintain a patent airway thus ensuring adequate oxygenation and ventilation. This refers to the insertion of a suction catheter through the nasal passage and pharynx into the trachea without a tracheal tube or tracheostomy (although a nasopharyngeal airway may be used) in order to aspirate accumulated secretions or foreign material. PREPARATION Before the procedure, you have to prepare the following: • • • • • • • • • • Suction Machine Suction Tubing/Tip Sterile Water Collecting Bottle Water-based Lubricant Oxygen Tank with Regulator and Humidifier Oxygen Mask B.V.M. Sterile Disposal Gloves Mask
The following should be monitored before, during and following the procedure:
• • • • • •
Breath sounds Skin color Breathing pattern and rate Pulse rate, dysrhythmia, electrocardiogram (EKG) if available Color, consistency, and volume of secretions Presence of bleeding or evidence of physical trauma
Open sterile suction package. With sterile gloves. Hyperoxygenate the patient by giving 100 cc of oxygen. • • • • • • • • • • . Place towel or waterproof pad across patient’s chest. Lower side rail closet to you. The dominant hand. Adjust bed to comfortable working position. Occlude Y-tube to check suction. whereas the nondominant hand is considered clean rather than sterile. touching only the outside surface. The dominant hand that will handle catheter must remain sterile. Or insert catheter along side of mouth toward trachea to suction the oropharynx. Apply suction by according suctioning port with your thumb. pick up sterile catheter and connect to suction tubing held with unsterile hand. and pour sterile saline into it. Moisten catheter by dipping it into container of sterile saline. Gently rotate catheter as it is being withdraw. if equipment is available Laryngospasm PROCEDURE • • Perform hand washing. Do not allow suctioning to continue for more than 10 to 15 seconds at a time. An unconscious patient should be placed in the lateral position facing you. Estimate the distance form earlobe to nostril and place thumb and forefinger of gloved hand at that point on catheter. Set up sterile container. Place patient in a semi-Fowler’s position if he or she is conscious. Slip catheter gently along the floor of an unobstructed nostril toward trachea to suction the nasopharynx. Gently insert catheter with suction off by leaving the vent on the Y-connector open. Never apply suction as catheter is introduced. Don sterile gloves.• • • • • Subjective response including pain Cough Oxygenation (pulse oximeter) Intracranial pressure (ICP). Flush the catheter with saline and repeat suctioning as needed and according to patient’s toleration of the procedure.
Prepare the needed materials to save time and energy. PROCEDURE PROPER • • Intermitently press the thumb regulator on the suction tip to avoid suffocation. Record and document patient’s initial Vital Signs to have baseline data for future comparison. Rinse suction tip every after insertion to get rid of mucus and secretions. NURSING RESPONSIBILITIES PRE-PROCEDURE • • • • • Position patient in a Semi-Fowler’s position to promote proper ventilation. . Hyperoxygenate patient to avoid hypoxia.• Use auscultation to listen to chest and breath sounds to assess effectiveness of suctioning. POST-PROCEDURE • ILLUSTRATION Oxygenate the patient to replace lost oxygen. Check the availability and functionality of the materials gathered.
Suction Machine Suction Catheter Tip .