Module 10: Suctioning Oropharyngeal, Nasopharyngeal and Tracheal

Question 1

Explain the purpose of suctioning

Answer 1

• remove saliva and other secretions
  
  • e.g. blood, vomit
• maintain patent airway
• facilitate ventilation
• obtain specimens
• maintain oral hygiene

Question 2

Compare and contrast the purposes of oropharyngeal, nasopharyngeal and tracheal suctioning

Answer 2

• suctioning of the mouth or nose and throat (pharynx)
• suctioning down the trachea - referred to as deep suctioning
• tracheal suctioning
  
  • increased risk of complications
  • should have physicians order
  • sterile technique must be used

Question 3

Yankauer

Answer 3

• rigid plastic or metal device
• used to suction the mouth
• change every 24 hours and prn
• patient can use independently
• use clean technique

Question 4

Pre Suctioning Assessment

Answer 4

• lung auscultation - crackles, course sounds
• respiratory rate and pattern
• obvious secretions
• audible respirations - gurgling
• decreased oxygen saturation
• shortness of breath (increased work of breathing)
• changes in pulse and/or blood pressure
• change in skin colour

Question 5

Post Suctioning Assessment

Answer 5

• appearance of suctioned secretions
• breath sounds
• respiratory rate, rhythm and depth
• O2 saturation
• skin colour
• presence of anxiety

Question 6

Identify the suction catheter sizes that are most appropriate for adults

Answer 6

• adult: 12-18 FR
• Children: 8-10 FR
• infants: 5-8 FR
  > Suction catheters
• sterile water or normal saline used as lubricant and to clear catheter
• suction pressure settings:
  
  • will depend on size of patient, consistency of secretions
  • adult 100-150 mmHg
  • child 100-120 mmHg
  • infant 80-100 mmHg
  • check agency policy for appropriate suction pressure setting
  • AHS - adult settings 100-120 mmHg
    > Suction Canister
• change as needed and when patient is discharged
• not measured as output
• needs to solidified prior to disposal

Question 7

Demonstrate the skill of suctioning a patient

Answer 7

Procedure for Suctioning
- upright position if tolerated
- insertion - do not apply suction
- apply intermittent suction for 10-15 seconds when removing catheter
- allow 60 seconds between suctioning passes
- assess need to repeat suctioning - do not perform more than 2 passes per catheter
- DO NOT force the catheter
- if patient on oxygen, remove for as short of time as possible
Secretions
- normal sputum tends to be watery and white or translucent
- tenacious or thick secretions may indicate dehydration
- yellow, tan, or green coloured secretions may indicate infection
- brown - coloured sputum may indicate prior bleeding
- red -coloured sputum indicates active bleeding

Question 8

Suctioning A Tracheostomy

Answer 8

• should not be done routinely - only prn
  
  • assess the need for suctioning
• sterile technique for 1st 72h, then clean technique
• always use sterile catheter and solution

Question 9

Report and document pertinent information during and after suctioning

Answer 9

• number of suction passes
• size of suction catheter
• quantity, colour, consistency and odor of secretions
• patients assessment and tolerance of the procedure
• if there is a change in the tracheal secretions, notify the physician to determine if sputum specimen should be collected and sent to lab