SUCTIONING

DEFINITION

Aspirating secretion through a catheter

connected to a suction machine or wall suction
outlet
Nasopharyngeal Oropharyngeal

Sites for suctioning

Endotracheal Tracheostomy
NASOPHARYNGEAL AND OROPHARYNGEAL
SUCTIONING
Definition
Removal of the secretion from the oral cavity or nasal cavity and pharynx
through the suction

Purposes
➢Removing the secretion from the airway
➢Facilitating the ventilation
➢Obtain the secretion for diagnostic purpose
➢Preventing the infection
 ENDOTRACHEAL AND TRACHEOSTOMY
SUCTIONING

Definition
Removal of secretion from tracheobronchial tree through an endotracheal
tube with the help of mechanical suction device

Purposes
➢Maintain the patient airway by removing the secretion
➢Prevention of respiratory tract infection from lodgment of secretion
 INDICATIONS FOR SUCTIONING
➢Noisy breathing
➢Patient inability to generate an effective spontaneous cough
➢Visible secretions in the airway
➢Suspected aspiration of gastric or upper airway secretions
➢Clinically apparent increased work of breathing
➢Deterioration of arterial blood gas
➢Patient requests suctioning
➢Low oxygen saturation
➢Radiological changes consistent with retention of pulmonary secretions
 SUCTION SOURCE
➢Portable suction
➢Wall suction unit
SUCTION CATHETER OF DIFFERENT
SIZE WITH COLOR CODE
AMOUNT OF NEGATIVE PRESSURE FOR
SUCTIONING

Portable suction unit Wall suction unit

Adult
8-15mm of Hg 100-120mmHg

Children 5-8mm of Hg
95-110mmHg

Infant
3-5mm of Hg 50-95mmHg
EQUIPMENT
➢Towel or moisture resistant pad
➢Portable or wall suctioning machine with tubing and collection receptors
➢Sterile disposable container for fluid
➢Sterile normal saline or water
➢Sterile gloves
➢Goggles or face shield
➢Sterile suction catheter ( half diameter of endotracheal tube diameter)
➢Water soluble lubricant
➢Sterile gloves
➢Moister resistant disposable bags
➢Sputum cup
 PROCEDURE
➢Explain the procedure to the patient even if patient unresponsive
➢Inform patient that suctioning may stimulate transient coughing or gagging (tell
that coughing helps to mobilize secretion)

➢Reassure the patient through out the procedure to minimize anxiety and fear
which can increase oxygen consumption

➢Wash your hands

➢Place the patient in semi-fowler’s or high fowler’s position to promote lung
expansion and effective coughing

➢Turn on the suction from the portable unit

PROCEDURE CONT…..
➢Set the pressure according to your facility’s policy
➢Occlude the end of the connection tubing to check suction pressure
➢Using strict aseptic technique, open the suction catheter kit, disposable
container and gloves

➢Consider your dominant hand sterile and your non dominant hand non sterile
➢Using your non dominant hand , pour the sterile water or saline in to the sterile
container

➢Pick up the catheter with your dominant hand and attach it to the connecting
tubing
PROCEDURE CONT…..
➢Use your dominant hand to control the suction valve while your dominant hand
manipulate the catheter
➢Instruct the patient to cough and breathe slowly and deeply several times before
beginning suction. Coughing helps loosen secretions and may decrease the
amount of suctioning necessary
➢Apply intermittent suction for no more than 5 seconds by placing and releasing
non dominant thumb over vent of catheter
➢ slowly withdraw catheter while rotating it back and forth between the
dominant thumb and forefinger
➢Encourage patient to cough
➢Replace oxygen device if applicable
 DOCUMENTATION

Record the procedure

➢ The amount
➢ Consistency
➢ Color
➢ Odor of the mucus
➢ Client breathing status before and
after
 COMPLICATIONS
➢Hypoxia
➢Vagal stimulation : cardiac arrhythmias
➢Tracheitis
➢Damage to mucus membrane
➢Airway occlusion
➢Bleeding disorders
 POINTS TO REMEMBER
➢Never suction more than 10 seconds at a time to prevent hypoxia
➢Do not apply suction pressure during insertion catheter
➢Pre-oxygenate the patient
➢Wait 3 minutes interval before each suction
➢Use gentle insertion and manipulation of catheter
➢ Use 0.9% saline prior to suctioning when needed to prevent infection
➢ monitor patient pulse
➢Follow strict aseptic technique
➢Suction patient only when need