TAGUM DOCTORS COLLEGE, INC.

Mahogany St., Rabe Subd., Tagum City

Telefax: (084) 655 – 6971 E-Mail: tdci_007@yahoo.com
Website: TagumDocollege.com

SUCTIONING THE NASOPHARYNGEAL AND OROPHARYNGEAL AREAS

The oropharynx extends behind the mouth from the soft palate above the level of the hyoid bone and contains
the tonsils. The nasopharynx is located behind the nose and extends
To the level of the soft palate. Oropharyngeal or nasopharyngeal suctioning is used when the client is able to cough
effectively but is unable to clear secretions by expectorating or swallowing.

Purposes:
1. To remove excess saliva or emesis from the oral cavity.
2. To clear the upper airway of mucoid secretions.
3. To promote adequate gas exchange.
4. To prevent pneumonia and atelectasis.
5. To obtain sputum culture.
6. To relieve respiratory distress.

Indications for Suctioning:

1. When the client starts to cough, and cannot expectorate respiratory secretions or has coarse bubbling or
gurgling noises with respiration.

Equipment:

 Suction apparatus
 Sterile suction catheter (with suction control port)
 Sterile water or saline
 Sterile container
 Sterile gloves
 Clean towel
 5 cc. syringe (for tracheostomy suctioning)
 Mask

Size of suction catheter Duration of Suctioning Intervals

Newborn: Fr. 6 3-5 seconds

Infant: Fr. 6-8 5-8 seconds 3-5 minutes
Child: Fr. 8-10 8-10 seconds
Adult: Fr. 12-16 10-15 seconds

Procedure

Action Rationale

1. Ascertain if there is a need for

suctioning by performing a
respiratory assessment.

2. Prepare equipment at the bedside. Preparation of equipment allows smooth

performance of the procedure without
interruption.

3. Wash your hands. Put on the mask. Handwashing deters the spread of
microorganisms.

4. Explain to the client how the procedure An explanation of the procedure relives
will help to clear the airway and relieve the client’s anxiety about procedure.
breathing problems. Explain that coughing,
sneezing or gagging is normal

5. Properly position the client. Positioning of the head to one side or

hyperextending the neck promotes
For conscious client: smooth insertion of the catheter into
the oropharynx or nasopharynx,
a. Semi-Fowler’s position with neck respectively.
hyperextended for nasal
suctioning.
 TAGUM DOCTORS COLLEGE, INC.
Mahogany St., Rabe Subd., Tagum City
Telefax: (084) 655 – 6971 E-Mail: tdci_007@yahoo.com
Website: TagumDocollege.com

b. Semi-Fowler’s position with neck

hyperextended for nasal suctioning.

For unconscious client:

c. Lateral position facing the nurse. The lateral position prevents the client’s
tongue from obstructing the client’s
airway, promotes drainage of
pulmonary secretions, and prevents
aspiration of gastrointestinal contents.

6. Place a towel on the pillow or under the Soiling of the bed linen or the client’s
client’s chin. bed clothes from secretions is
prevented. Secretions on the towel can
be discarded, thus reducing spread of
bacteria.

7. Turn the suction on to the appropriate Proper suction pressure provides safe,
pressure if applicable. negative pressure according to the
client’s age. Excessive negative
pressure can precipitate pneumothorax.

8. Pour sterile water or NSS into sterile Sterile solution is needed to lubricate
container. the catheter to decrease friction and
promote smooth passage of the
catheter.

9. Hyper oxygenate the client for 1-2mins. Providing increased percentage of

oxygen decreases the risks of hypoxia.

10. Peel back the wrapper of the catheter To facilitate easy removal of the
until the adapter is exposed. catheter from the wrapper.

11. Apply a sterile glove to your dominant The sterile gloves maintains asepsis
hand. Remove wrapper around the catheter as catheter is passed into the client’s
with the non-dominant unsterile hand. mouth or nose.
coil the catheter around your dominant hand
using fingers as you remove it from the
wrapper.

12. Holding the sterile suction catheter with To prevent contamination.

the gloved hand, connect it to the
suction tubing that is held with the unsterile
hand.

13. Approximate the distance between the
client’s ear lobe and tip of the nose and
place the thumb and forefinger of gloved
hand at that point (6-8inches).
trachea.
This distance ensures that the suction
catheter remains in the pharyngeal
region. Insertion of the catheter past
this point places the catheter into the

14. Moisten the catheter tip with sterile Moistening the catheter tip reduces
solution. Apply suction with catheter friction and eases insertion of catheter.
tip in the solution. Applying suction while the catheter is in
the sterile solution ensures that suction
equipment is functioning before
catheter is inserted.

15. Suction:

a. For nasopharyngeal suctioning, The catheter avoids the nasal turbinates

gently insert catheter into one and enters more easily into nasopharynx
nostril. Guide the catheter medially to the oral and nasal mucosa during
along the floor of the nasal cavity. catheter insertion.
Do not force the catheter. If one
nostril is not patent, try the other.
Do not apply suction during
insertion.

2
 TAGUM DOCTORS COLLEGE, INC.
Mahogany St., Rabe Subd., Tagum City
Telefax: (084) 655 – 6971 E-Mail: tdci_007@yahoo.com
Website: TagumDocollege.com

b. For oropharyngeal suctioning, Stimulation of the gag reflex is reduced.

gently insert catheter into one
side of the mouth and slide the
catheter to the oropharynx. Do
not apply suction during insertion.

16. Apply suction by occluding the suction Occluding of suction port activates suction
control port with the thumb of unsterile pressure. Suctioning is intermittently done
hand. Gently rotate the catheter with as the catheter is withdrawn. Rotation
the thumb and index finger of the removes secretions from all surfaces
of gloved hand as you withdraw it. of the airway and prevents trauma from
suction pressure on one area. Suctioning
also removes air. The client’s oxygen
The entire suctioning procedure should supply could be severely reduced if the
not last more than 15 minutes. procedure lasts longer than 15 seconds.
The interval between suctioning provide
the client with the opportunity to increase
his oxygen intake.

17. Flush the catheter with sterile Flushing the catheter with sterile solution
solution by placing it in the solution removes secretions from the catheter and
and applying suction. lubricates the catheter for the next
suctioning.

18. If the client is able, ask him to deep Deep breathing and coughing promote
breathe and cough between suctions. mobilization of secretions to the upper
airway where they can be removed with
the catheter. If the client is able to cough
productively, further suctioning may not be
needed if his airway is clear upon
auscultation.
If suctioning is needed, repeat steps 14-16.

The interval between suctioning should be

atleast 3-5 minutes. Hyperoxygenate the
client during the interval period.

19. Suction secretions in mouth or under Asepsis is maintained. The mouth should
tongue after suctioning the oropharynx or be suctioned only after the sterile areas
nasopharynx. are thoroughly suctioned.

NOTE: If suctioning is to be done

constantly, use a separate suction cath
for each orifice. Properly label them and
maintain sterility.
20. When procedure is completed, turn off Keeping contaminated articles confined to
suction machine. Dispose gloves and to certain areas limits the transmission of
catheter properly. Wash your hands. microorganisms. Handwashing deters the
spread of bacteria.

21. Offer oral hygiene. Place client in This displays concern for the client’s
comfortable position. comfort because suctioning makes the
oral mucosa drug.

22. Use auscultation to listen to the chest Listening to the lung sounds helps
to assess the effectiveness of suctioning. determine whether the respiratory
passageways are clear of secretions.

23. Record the time of suctioning amount, Recording this information documents
consistency, color and odor of secretions that the procedure was completed and the
and the client’s response to the procedure. client’s status during and after the
Empty suction bottle at the end of every shift. procedure.

Note: Store the catheter according to the agency’s or doctor’s preference.

3
 TAGUM DOCTORS COLLEGE, INC.
Mahogany St., Rabe Subd., Tagum City
Telefax: (084) 655 – 6971 E-Mail: tdci_007@yahoo.com
Website: TagumDocollege.com

Sample Documentation:

Date Time Nurse’s Notes

2/22/2013 8:30 AM Gargling respirations audible. Nasal

flaring noted. R-30, P-100 and regular,
BP-140/190.
Encouraged to breathe deeply and to
cough. Unable to cough out secretions
effectively.
8:35 AM Oropharyngeal hygiene done. Suctioned a
moderate amount of yellowish, viscous
secretions. Encourage to do deep
breathing. RR-24. Abnormal respiratory
sounds not noted. Mouth wash done.
Encourage to take more fluids p.o.