Scribd Logo
Upload

Welcome to Scribd!

  • 684 views

    Suctioning

    Uploaded by

    Angie Mandeoya
    The document outlines the procedure for endotracheal or tracheostomy suctioning to remove mucous from the lungs and airways of patients who have difficulty breathing or coughing. It details the necessary equipment, steps to perform the procedure while maintaining sterility, and important precautions to minimize risks of suctioning such as hypoxemia, atelectasis, and infection. The goal of suctioning is to keep the airway clear and improve oxygenation and breathing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Suctioning

    Uploaded by

    Angie Mandeoya
    684 views15 pages
    The document outlines the procedure for endotracheal or tracheostomy suctioning to remove mucous from the lungs and airways of patients who have difficulty breathing or coughing. It details the necessary equipment, steps to perform the procedure while maintaining sterility, and important precautions to minimize risks of suctioning such as hypoxemia, atelectasis, and infection. The goal of suctioning is to keep the airway clear and improve oxygenation and breathing.

    Original Description:

    Suctioning

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document outlines the procedure for endotracheal or tracheostomy suctioning to remove mucous from the lungs and airways of patients who have difficulty breathing or coughing. It details the necessary equipment, steps to perform the procedure while maintaining sterility, and important precautions to minimize risks of suctioning such as hypoxemia, atelectasis, and infection. The goal of suctioning is to keep the airway clear and improve oxygenation and breathing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    684 views15 pages

    Suctioning

    Uploaded by

    Angie Mandeoya
    The document outlines the procedure for endotracheal or tracheostomy suctioning to remove mucous from the lungs and airways of patients who have difficulty breathing or coughing. It details the necessary equipment, steps to perform the procedure while maintaining sterility, and important precautions to minimize risks of suctioning such as hypoxemia, atelectasis, and infection. The goal of suctioning is to keep the airway clear and improve oxygenation and breathing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    Suctioning

    is a method of removing mucous from the lungs.


    People with a spinal cord and/or brain injury may have problems breathing due to
    congestion.
    The muscles that help with breathing and coughing may not work well.
    will help keep the airway clear.
    perform as sterile procedure only when patient needs it and not on a routine
    schedule.
    Observe for hypoxemia, atelectasis, bronchospasms, cardiac dysrhythmias,
    hemodynamic alterations, increased intracranial pressure, and airway trauma.
    ENDOTRACHEAL/ TRACHEAL SUCTIONING
    PROCEDURE
    OBJECTIVES:
    The nurse performs endotracheal and tracheostomy suctioning to:
    Maintain a patent airway.
    To improve oxygenation and reduce the work of breathing.
    To remove accumulated tracheobronchial secretions using sterile
    technique.
    Stimulate the cough reflex.
    Prevent pulmonary aspiration of blood and gastric fluids.
    Prevent infection and atelectasis.
    EQUIPMENT:

    Sterile normal saline


    Suction source
    Ambu bag connected to 100% O2
    Clear protective goggles/mask or face shield
    Sterile gloves for open suction
    Clean gloves for (in-line) closed suction
    Sterile catheter with intermittent suction control port or In-line suction
    catheter
    Steps Rationale
    Wash hands. Reduces transmission of microorganisms
    Assess patients need for suctioning. Since endotracheal suctioning can be
    hazardous and causes discomfort, it is
    not recommended in the absence of
    apparent need.
    Coarse breath sounds
    Coughing; increased respirations
    Increased PIP on ventilator
    Don goggles and mask or face shield.
    Turn on suction apparatus and set Potential for contamination
    vacuum regulator to appropriate Significant hypoxia and damage to
    negative pressure. Recommend 80-120 tracheal mucosa can result from
    mmHg; adjust lower for children and the excessive negative pressure
    elderly.
    Prepares suction apparatus. Secure one
    end of connecting tube to suction
    machine, and place other end in a
    convenient location within reach
    Use in-line suction catheter or open
    sterile package (catheter size not
    exceeding one-half the inner diameter
    of the airway) on a clean surface, using
    the inside of the wrapping as a sterile
    field.
    Prepares catheter and prevents
    transmission of microorganisms.
    Catheter exceeding one-half the
    diameter increases possibility of
    suction-induced hypoxia and
    atelectasis.
    Prepare catheter flush solution.With in-
    line catheter use sterile saline bullets to
    flush catheter. With regular suctioning
    set up sterile solution container and
    being careful not to touch the inside of
    the container, fill with enough sterile
    saline or water to flush catheter.
    With in-line suction catheter use clean Maintain sterility. Universal precautions.
    gloves.
    With regular suctioning, done sterile In regular suctioning the dominant hand
    gloves. must remain sterile throughout the
    procedure.
    Pick up suction catheter, being careful Maintains catheter sterility. Connects
    to avoid touching nonsterile surfaces. suction catheter and connecting tubing
    With nondominant hand, pick up
    connecting tubing. Secure suction
    catheter to connecting tubing.
    Ensures equipment function. Check
    equipment for proper functioning by
    suctioning a small amount of sterile
    saline from the container. (skip this step
    in in-line suctioning)
    Remove or open oxygen or humidity
    device to the patient with nondominant
    hand. (skip this step with in-line
    suctioning). Opens artificial airway for
    catheter entrance. Have second person
    assist when indicated to avoid
    unintentional extubation.
    Replace O2 delivery device or reconnect
    patient to the ventilator
    Hyperoxygenate and hyperventilate via
    3 breaths by giving patient additional
    manual breaths on the ventilator before
    suctioning. Hyperoxygenation with
    100% O2 is used to offset hypoxemia
    during interrupted oxygenation and
    ventilation. Preoxygenation offsets
    volume and O2 loss with suctioning.
    Patients with PEEP should be suctioned
    through an adapter on the closed
    suction system.
    Without applying suction, gently but Application of suction pressure upon
    quickly insert catheter with dominant insertion increases hypoxia and results
    hand during inspiration until resistance in damage to the tracheal mucosa.
    is met; then pull back 1-2 cm. Catheter
    is now in tracheobronchial tree.
    Apply intermittent suction by placing
    and releasing dominant thumb over the
    control vent of the catheter.
    Rotate the catheter between the
    dominant thumb and forefinger as you
    slowly withdraw the catheter.
    With in-line suction, apply continuous Intermittent suction and catheter
    suction by depressing suction valve and rotation prevent tracheal mucosa when
    pull catheter straight back. Time should using regular suctioning methods. Unable
    not exceed 10-15 seconds. to rotate with closed- suction method.

    Replace oxygen delivery device. Reduces incidence of hypoxemia and


    Hyperoxygenate between passes of atelectasis.
    catheter and following suctioning
    procedure. Replenishes O2. Recovery to
    base PaO2 takes 1 to 5 minutes
    Rinse catheter and connecting tubing Removes catheter secretions.
    with normal saline until clear.
    Monitor patients cardiopulmonary . Observe for signs of hypoxemia, e.g.
    status during and between suction dysrhythmias, cyanosis, anxiety,
    passes bronchospasms, and changes in mental
    status.

    Once the lower airway has been The catheter is contaminated after nasal
    adequately cleared of secretions, and oral pharyngeal suctioning and
    perform nasal and oral pharyngeal or should not be reinserted into the
    upper airway suctioning. Removes upper endotracheal or tracheostomy tube.
    airway secretions.
    Upon completion of upper airway Reduces transmission of
    suctioning, wrap catheter around microorganisms.
    dominant hand. Pull glove off inside
    out. Catheter will remain in glove. Pull
    off other glove in same fashion and
    discard. Turn off suction device.
    Reposition patient. Supports promotes comfort; communicates
    ventilatory effort; caring attitude.

    Reassess patients respiratory status. Indicates patients response to


    suctioning

    Dispose of suction liners and Decreases incidence of organism


    connecting tubing, sterile saline colonization and subsequent
    solution every 24 hours and set up pulmonary contamination. Universal
    new system precautions.
    PRECAUTIONS:
    1. Minimize suctioned-induced atelectasis and hypoxemia:
    a. Avoid using catheters larger than one-half the diameter of the
    airway.
    b. Administer one or more postsuctioning hyperinflations, using
    manual or sigh breaths on the ventilator or ambu bag if not
    ventilated.
    2. Maintain rigorous sterile technique when suctioning the intubated
    patient.
    Impaired pulmonary defense systems and invasive instrumentation of
    the pulmonary tract predisposes these patients to colonization and
    infection.
    Never use same catheter to suction the trachea after it has been used in
    the nose or the mouth.
    3. Limit the frequency of suctioning and avoid, as much as possible,
    catheter impaction in the bronchial tree when the patient is
    anticoagulated or when hemorrhage from suction-induced trauma is
    evident.
    4. Minimize the frequency and duration of suctioning when patient is
    on positive end-expiratory pressure (PEEP) greater than 5 cm or
    continuous positive airway pressure (CPAP).
    Small suctioning-induced changes may have profound effects on these
    marginally oxygenated patients.
    5. Maintain awareness of the limitations of ET/tracheal suctioning.
    Maneuvers and catheter design have been proposed to increase the
    likelihood of passage into the left bronchus; however, these have been
    shown to be of limited success.
    Because the left main stem bronchus emerges from the trachea at the
    45-degree angle from the vertical, suction catheters are almost
    inevitable passed into the right bronchus (when they pass the carina)
    despite head-turning, etc.
    6. The use of saline installations for loosening secretions has been
    controversial and recent research shows that in fact it is detrimental
    and poses a greater risk of pneumonia for the patient.
    POTENTIAL COMPLICATIONS

    Hypoxemia
    Atelectasis
    Dysrhythmias
    Nosocomial pulmonary tract infection
    Sepsis
    Mucosal trauma with increase secretions
    Cardiac arrest

    You might also like