Suctioning

Question 1

Indication for suctioning on MV

Answer 1

Central crackles over patients trachea
Visible secretions in the artificial MV airways.
Coughing of patients.
Deterioration in oxygen saturation level or ABG abnormalities
Saw-tooth pattern on flow volume loop of ventilator monitor.
Increased PIP during volume mode ventilation.
Decreased tidal volume during pressure mode ventilation
Signs of acute respiratory distress.

Question 2

Contraindications for suctioning

Answer 2

Frank haemoptysis
Severe bronchospasm
Compromised CVS
Nasal suctioning on skull fracture
Pulmonary oedema.
Clotting disorders platelets below 50
Nasopharyngeal suction in stride and acute facial fracture
Pulmonary hypertension
Patient with recent oesophageal or trachea anastomoses or tracheo-oesophageal fistula

Question 3

Indications for closed suctioning

Answer 3

PEEP greater than 10
Mean airways pressure greater than 20
FiO greater than 0.6
Mechanically ventilated patient requiring frequent suctioning
Hemodynamic instability associated with ventilator disconnection.
Mechanically ventilated patient with acute pulmonary TB