SUCTION

Suctioning is a technique used to

extract secretions from the
respiratory tract.
It also removes some amount of
air.
TYPES OF SUCTION
Open
The ventilator tubing is
disconnected.
Suction
Closed
The ventilator tubing is
connected.

*There is better physiologic stability, less oxygen desaturation and fewer

dysrhythmias in the case of closed suctioning.
PHASES OF SUCTION
1. BEFORE SUCTIONING
• The patient is assessed and prepared.
• Hyperoxygenation with 100% oxygen is done for 3-5 breaths.
• Proper catheter size is ensured.

2. DURING SUCTIONING
• Know the appropriate depth of insertion.
• Know the time limit for the procedure.
• Decide the number of passes of the catheter.
• Monitor pulse oximetry.

3. POST SUCTIONING
• Reassure and position the patient comfortably.
• Reconnect to ventilator (in case of open ventilation).
PROCEDURE
• Explain the process to the patient so that he is not
apprehensive. This enhances cooperation from patient.
• Medicate post-op patients before suctioning to reduce
pain due to coughing.
• Maintain aseptic conditions.
• POSITION: Fowler (60-70 flexion) or semi Fowler
(~45 flexion) with neck hyperextension
• Moisten catheter with sterile saline/water-soluble gel.
• Place the catheter upward and backward in small
increments and insert upto the carina.
• Withdraw the catheter 1 cm above carina.
• Suction while rotating and withdrawing the catheter to
cover a larger area.
*ALLOW THE PATIENT TO REST IN BETWEEN
SUCTIONS, AND IF NECESSARY, VENTILATE
HIM OR HER A FEW MINUTES BEFORE EVERY
SUCTION.
PRECAUTIONS
• Do not suction the trachea with the same catheter as
the pharynx. The reverse can be done.
• Each suction should last not more than 5-10s to
avoid hypoxia.
• Use the lowest possible vacuum setting to reduce the
risk to tracheal mucosa.
• Avoid kinking the suction tube/catheter to avoid
removal of the tracheal mucosa.
• Use goggles to avoid contact with coughed out
secretions.
COMPLICATIONS
• Hypoxemia (can lead to tissue hypoxia)
• Cardiac dysrhythmia
• Bronchospasm
• Infection
REFERENCE
• Cardiovascular and Pulmonary Physical Therapy
Evidence to Practice — Donna F., Elizabeth
Dean