Suctioning and Care of an Artificial Airway

Question 1

What is the procedure for the oropharyngeal suctioning?

Answer 1

Fill basin with 100mL sterile water or water (agency protocol)
Apply glove/s
Open Yankauer suction catheter package. Do not allow to touch any nonsterile surfaces.
Pick up yankauer with gloved hand and attach to suction tubing.
Place tip of yankauer in sterile water and suction small amount
Insert yankauer into mouth. Apply suction intermittently and suction around mouth, including pharynx and gum line until secretions cleared.
Clear yankauer using sterile water.

Question 2

What is the procedure for Nasopharyngeal suctioning?

Answer 2

Fill basin with 100mL sterile water
Apply gloves
Open suction catheter package. Do not allow to touch any nonsterile surfaces.
Pick up catheter and attach to suction tubing
Lightly coat distal 2-3 inches of catheter tip with lubricant
Without applying suction using dominant thumb and forefinger gently insert catheter into naris during inhalation
Instruct patient to take a deep breath and insert catheter and advance to back of pharynx. Do not force.
Insert 6-8 inches in adults and older children and 3-51/2 inches in young children and infants
Apply intermittent suction for no more than 15 seconds using thumb. Slowly withdraw catheter while rotating it back and forth.
Clear catheter using sterile water.
Assess for need to repeat. Allow at least 1 minute between passes.

Question 3

What is the procedure for Nasotracheal suctioning?

Answer 3

Fill basin with 100mL sterile water
Apply gloves
Open suction catheter package. Do not allow to touch any nonsterile surfaces.
Pick up catheter and attach to suction tubing
Lightly coat distal 2-3 inches of catheter tip with lubricant
Without applying suction using dominant thumb and forefinger gently insert catheter into naris during inhalation
Instruct patient to take a deep breath and quickly insert catheter and advance to Just above entrance to trachea. Patient will begin to cough. Then pull back catheter ½ inch before suctioning.
Insert 6-8 inches in adults and older children and 3-51/2 inches in young children and infants
Apply intermittent suction for no more than 10 seconds using thumb. Slowly withdraw catheter while rotating it back and forth.
Clear catheter using sterile water.
Assess for need to repeat. Allow at least 1 minute between passes.

Question 4

What is the procedure for the artificial airway suctioning?

Answer 4

Apply mask and goggles
Sets pressure of suction
according to agency policy
Open catheter package
Apply sterile glove to dominant hand
Using non-dominant hand pours sterile water into reservoir
Pick up catheter in dominant hand.
Pick up tubing in non-dominant hand and secure to catheter.
Partner:
Places client in a semi-fowler’s position if not contraindicated.
Attaches AMBU-bag
to oxygen source and adjusts
flow of oxygen to 100%. Connect to artificial airway
If client does not have copious secretions:
Hyperoxygenates compressing AMBU-bag 3-5 times as client inhales
Flushes and lubricates catheter using sterile water.
Without applying suction gently but quickly insert catheter using dominant thumb and forefinger into artificial airway until you meet resistance or patient coughs. Pull back ½ inch.
Applies intermittent suction using thumb and slowly withdraw catheter while rotating back and forth for no longer than 10 seconds.
Encourage patient to cough
Watch for respiratory distress
Rinse catheter using sterile water.
Partner:
Hyperoxygenate using AMBU-bag
Assess need to repeat.
Allow 1 minute between passes.

Question 5

What is the procedure for the care of a tracheostomy?

Answer 5

Washes and dries hands prior 
to beginning procedure
Checks physician order 
Gathers supplies
Introduces self to client, checks
ID and explains activity.
Position patient
Place towel over chest
Prepare kit
Apply sterile gloves
Partner:
Hyperoxygenate patient
Remove oxygen source
Unlock and remove inner cannula
with non-dominant hand and place
into normal saline
Replace oxygen source
Pick up inner cannula and use
small brush to remove secretions
inside and out
Rinse with normal saline using
Non-dominant hand to pour
Replace inner cannula and lock
Partner:
Hyperoxygenate patient
Clean area around stoma with
cotton tipped applicators and 4X4
gauze
Use a circular motion from inside
working out using dominant hand
Dry thoroughly using dry 4X4
Instruct partner to hold
tracheostomy tube securely in
place.
Cut ties
Replace old ties with clean
Place clean drain sponge
Under faceplate
Replace oxygen

Documents intervention and
assessments