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PY2003 CVR practice > Suctioning and Manual Hyperinflation > Flashcards

Suctioning and Manual Hyperinflation Flashcards

1
Q

Who would you use suctioning on and why?

A

Used for nursed, supine and sedated patients who have a absent/minimal cough reflex and can’t clear their airways of secretions.
Used when a pt has an artificial airway and so is not capable of effective coughing. The application of negative pressure is called suctioning.

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2
Q

What techniques are available for secretion mobilisation?

A
  • deep breath
  • incentive spirometry
  • manual/ventilator hyperinflation
  • repositioning
  • manual techniques
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3
Q

What techniques are available for secretion removal?

A
  • FET/cough
  • Guedel suction
  • Yankaeur suction
  • NP suction
  • Closed suction
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4
Q

What are the 3 main ways airway suction can be carried out?

A
  1. Nasopharyngeal (NP)
  2. Oropharyngeal
  3. Mini-tracheostomy
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5
Q

Describe how you would place an NP airway into a pt

A

Measure from tip of nose to tip of ear.
Open end of tube is inserted facing up and is then twisted once within the airway.
When inserting, aim the tube at the corner of the opposite eye

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6
Q

Describe how you would place an oropharyngeal airway into a pt

A

Measure from corner of mouth to the angle of the jaw.

Insert OPA inverted (pointing up) against the hard palette and then rotate it to face down the airway

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7
Q

When would you use a oropharyngeal airway?

A

With an unresponsive pt with an absent gag reflex

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8
Q

What indications would make you clinically reason suctioning?

A

Secretions are accessible by catheter, and crackles can be heard on auscultation
Intubated pts with evidence of secretions
Pts are unable to clear by any other means

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9
Q

What is the most important thing to remember before you begin suctioning on a pt?

A

CONSENT!

If it can not be gained verbally or in writing, then it is done in the best interest and documented accordingy

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10
Q

What are some hazards that can occur from suctioning?

A
  • Bradycardia (HR below 60bpm)
  • Hypoxia
  • Infection
  • Distress
  • Pain
  • Cough/ Gag
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11
Q

When would you not use suctioning?

A
  • facial trauma
  • skull factures
  • thoracic surgery
  • clotting disorders
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12
Q

What position is best for suctioning?

A

Patient is upright or side lying in case of vomiting

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13
Q

How can you measure the effectiveness of suctioning?

A
  1. oxygenation
  2. auscultation - reduced crackles
  3. sputum volume
  4. patient reporting
  5. CXR
  6. WOB
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14
Q

When is manual hyperinflation (MHI) used?

A

This technique is used in patients with an artificial airway who are mechanically ventilated or have a tracheostomy
This method of airway clearance promotes the mobilisation of secretions and re-inflates collapsed areas of the lung

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15
Q

What does MHI do?

A
  • clears retained secretions
  • used when collapse or consolidation is present
  • improves oxygenation
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16
Q

What are the benefits of inspiratory holds?

A
  • allows time for alveolar inflation
  • allows recruitment of collapsed alveoli. When one collapsed alveoli is recruited it will then recruit neighbouring ones as the adjoining ones share walls. This is called alveolar interdependence.
17
Q

How does MHI help with secretion clearing?

A
  • used to re-expand areas of atelectasis and aids the removal of secretions
  • increases tidal volume and allows time for the alveoli and collateral airways to open
  • this increases the elastic recoil of the lungs and chest and so increases the expiratory flow rate
  • expiratory>inspiratory flow rate allows secretion clearance
18
Q

What are the benefits of MHI?

A
  • clearance of retained secretions
  • assists with collapse and consolidation
  • improves oxygenation
19
Q

What hazards are associated with MHI?

A
  • reduced BP
  • distress
  • barotrauma
20
Q

When would you not use MHI?

A
  • undrained pneumothorax
  • cardiovascular instability
  • acute head injury
21
Q

Explain how the steps in MHI help the pt

A
  1. Slow inspiratoty phase
    - helps to overcome lung collapse
  2. Inspiratory pause
    - lung recruitment through alveolar interdependence
  3. Quick release
    - creates annular flow to mobilise secretions centrally
22
Q

How do you measure the efffectiveness of MHI?

A
  • oxygenation
  • secretion clearance
  • auscultation
  • CXR
  • cardiovascular stability

PY2003 CVR practice (7 decks)

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