Airway Maintenance Flashcards
why do we suction pts
to keep nose, mouth and trachea free of excessive secretions
prevent atelectasis and pneumonia
collect sputum for testing
what indications would you suction a pt
if a pt is unable to effectively cough
-AND airway is compromised/ with decreased o2
what equipment do you need for oral pharyngeal suctioning
Yankauer(tonsil tip suction) suction device/tubing towel PPE (gloves mask goggles) cup of water suction canister/tubing
what should a suction be set at on adults?
children?
adults- 100-150mmHg
child- 100-120mmHg
for a nasopharyngeal/nasotracheal suctioning what size catheters should be used
infants-5-8F
children-8-10F
adults 12-18F
what is the suctioning rate for nasopharyngeal/nasotracheal suctioning
adults 100-120mmHg
child 50-100mmHg
what position should the pt be in when being suctioned
high fowlers and head is hyperextended throughout the procedure.
want to prevent the suction from going into the trachea
how long should you perform nasopharyngeal/nasotracheal suctioning
no longer the 15 seconds
if the pt needs more suctioning- let them recover and go down again
how many times should you attempt nasopharyngeal suctioning in one procedure
no more than 3 passes in one session.
allow 20-30 seconds between suctioning attempts
what are the goals for suctioning
airway cleared of secretions
improved breath sounds
oxygenation improves
what are complications of suctioning
hypoxia (sats drop- need to get sats back up into the 90s) cardiac dysrhythmias hypotension tachycardia vomiting/aspiration mucosal trauma and bleeding
what are things you need to do after suctioning prior to leaving the room
- reset O2 at ordered rate
- reassess lung sounds, respiratory status, O2 sats
- Reposition pt
- Rinse tubing
- dispose of catheter
steps for oral-pharyngeal suctioning
- sit pt upright
- place towel across chest
- insert catheter or yankauer into mouth along gum line to pharynx
- move around until secretions are clear
- encourage pt to cough
when does suctioning need to be sterile
when it passes the pharynx and enters the trachea
or if you are performing
nasopharyngeal
what is the pt position for nasotracheal suctioning
semi or high fowlers
with head HYPERextended to open airway
how do you know if you have gone in far enough with nasotracheal suctioning
when you meet resistance and/or stimulate a strong cough
how do you prevent hypoxia when suctioning a pt.
hyperoxgynate the patient prior to suctioning and after suctioning
if they are on 2L turn up the o2 to 4-6 L
why do you suction the mouth first if there are a lot of secretions present
because the mouth has a lot of bacteria that can cause infection if they are introduced to the trachea via suction
what should be documented when suctioning is performed
- the type of suctioning technique
- the number of attempts
- how the pt tolerated the procedure
- any adverse effects that occured
- the secretion description
why would a cuff tracheostomy be used
- to decrease the risk of aspiration
- to prevent leakage of air
- permit mechanical ventilation
when would a pt have an uncuffed tracheostomy
- in smaller children
- in an established tracheostomy without the need for mechanical ventilation
what must be done before a pt can speak with a tracheostomy
- it must be a fenestrated tracheostomy
- the inner cannula needs to be removed and the cuff deflated
what will happen if the fenestrated tracheostomy is plugged while the inner cannula is in palce
it will lead to suffocation because the tracheostomy will be plugged and that is the only source of air flow
how do you suction a fenestrated tracheostomy
the same as a regular tracheostomy except
the inner cannula MUST be replaced PRIOR to suctioning
if its not the catheter can pass through the fenestra and injure the tracheal wall
