suctioning Flashcards
ETT tube of entry
patients who are intubated and ventilated= lack of cough reflex.
When intubated patients do cough secretions there is nowehre for them to go so suctioning is the only way to eliminate them and prevent the rube from becoming blocked. Performed every 4-6 hours
What is suctioning
involves the removal of pulmonary secretions from the respiratory trac, by artificial means, using applied negative pressure. Should last no longer than 15 secs.
why do we suction ventilated patients
removal of bronchial secretions is important for gas exchange. Stasis of secretions= risk of infection.
impact of an artificial airway on normal mucus clearance
Suctioning clears tracheostomy tube
Methods of suctioning via an artificial airway
there are 2 methods of suctioning through an ETT or tracheostomy tube when a patient is ventilated.
Open suction - patient temporarily removed and disconnected from the ventilator.
Closed suction- patient remains attached, involves permanent attachment of sterile resusable in-line.
advantages of closed
reduced loss of 02 and PEEP, reduced infection risk,
saline instillation
normal saline instillation is sometimes used prior to suctioning- directly into trachea via an artificial airway. May assist removal of secretions, warm the saline to reduce bronchospasm.
complications of suctioning
hypoxia/hypoxaemia, Cardiac arrest, tissure trauma, atelectasis, bronchospasm, infection, increased ICP, increased or decreased BP, psychological effects, pneumothorax
Minimising risk of complications
pre and post oxygenate.
10-15secs
chose correct catheter size and design,
choose correct suction pressure
do not twist the catheter,
use a sterile technique
wear apron, gloves and vistor
suction only when neccesary
catheter sizes
there are number of different sized catheters- based on diameter.
Calculate correct catheter size- use the ETT or tracheostomy tube size, minus 2 from this figure and then times by 2
suctioning patient when ventilated
pre oxygenate the patient with 100% oxygen, if open, disconnect the patient from ventilation.
Insert cathetor gently into airway as far as it will go- stop when reach resistance or the patient coughs, withdraw 0.5cm and apply suction
Immediately reattach patient to the ventilator.
wind cathetor around glove and turn isnide out
suctioning when patients are not ventilated
deep suctioning is sometimes required in non ventilated patients with an inability to cough to manage retained secretions.
Access through the nose or mouth and into the trachea to remove secretions from the upper respiratory tract and trachea
how are retained secretions evidence
visible, audible or palpable secretions, decreased O2 sats, increased O2 requirements, poor cough, reduced movement, signs of distress
Other routes of entry for non-ventilated
Uses of a guedel oral airway
when to use a size 10 catheter (black)
minitracheostomy, nasal-pharyngeal airway, nasal-pharyngeal without airway
