Week 9- Suction and Tracheostomy Management

Question 1

What is suctioning used for?

Answer 1

Clear the airway of: vomit, saliva, blood, food, foreign objects

Question 2

When can you suction during a call?

Answer 2

ANYTIME

Question 3

Goal of suction=

Answer 3

to CLEAR the airway

Question 4

All EMS ambulances must have: (3)

Answer 4

a portable suction device
hand held device
wall unit in ambulance

Question 5

Lateral Compact Suction unit:
(holds how much? battery life?)

Answer 5

holds 300mLs
45 min battery life
light weight

Question 6

S Cort Suction unit
(suction rate?)

Answer 6

light weight
500mmHg for adults
125mmHg for children
disposible canister

Question 7

Different suction catheters:

Answer 7

Widebore- used in mouth
Yankeur- used in mouth
In line/closed suction- nose, trach, down ETT

Question 8

Oral SUCTION PRESSURES

Answer 8

adult= 500- 550 mmHg
children= 200-220 mmHg
infant= 80-100mmHg

Question 9

Deep SUCTION PRESSURES

Answer 9

adult= 100-150mmHg
children= 100-120mmHg
infant= 60-100mmHg

Question 10

How do you suction the oropharynx?

Answer 10

open pt’s airway and insert suction tip/catheter
NEVER go passed the base of the tongue (could trigger gag reflex)
suction for 5-10 sec on the way OUT!

Question 11

Oropharynx suctioning procedure:

Answer 11

roll or sit up pt withe larger amounts of secretions
set correct pressure for the pt
put the catheter or large bore in mouth
occlude the hole to initate the suction
suction of the way out for 5-10 secs
pt requires oxygenation between attempts for 1 min

Question 12

Tracheostomy suctioning procedure:

Answer 12

set correct pressure for the pt
put the catheter in until you feel resistance
occlude the hole to initiate the suction
suction of the way out for 5-10 secs, oxygenate in between for 1 min

have saline to clean catheter

Question 13

Inline closed suction is only for:

Answer 13

ETT (intubation) and TRACHEOSTOMY
- most used
- less germs spread
- able to use with BVM
procedure is same as trach suction

Question 14

REMEMBER: Only suction as far as you can_____

Answer 14

SEE !!!!

Question 15

Parts of a tracheostomy: (4)

Answer 15

Inner cannula
Neck plate (all the info is here)
Ties or straps
Obtorator

Question 16

Indications of a trach reinsertion:

Answer 16

• pt w existing tracheostomy tube where the inner and outer cannula have been removed from the airway
• resp distress AND
• inability to adequately ventilate AND
• there is no family or caregiver who is available and knowledge to replace trach cannula

Question 17

Steps to reinsert –>

Answer 17

1. ASK family member, encourage them to do it!!
2. Attempt twice MAX
   Ensure SPO2 is applied, check if pt breaths via the mouth or JUST trachea
3. Ventilate them
   - If via the mouth: dressing to the stoma
   -If by the trach: place the o2 mask or BVM directly over the tracheostomy

Question 18

What is a laryngectomy?

Answer 18

removoval of the larynx= no connection between mouth and trachea

Question 19

What is the most common trach problem?

Answer 19

Obstructed by mucous! Suction first!!

Question 20

What is ETCO2?

Answer 20

End tidal Carbon Dioxide
- the level of CO2 that is released at the END of an exhaled breath
- reflects the adequacy of CO2 that is being carried back into the lungs and exhaled

Question 21

What is a normal ETCO2 value?

Answer 21

35-45mmHg

Question 22

What is ETCO2 an indication of?

Answer 22

VENTILATION

Question 23

What does Increased resp rate: hyperventilation in terms of ETCO2…

Answer 23

blowing off CO2= decreased ETCO2 value

Question 24

What does decreased resp rate: hypoventilation in terms of ETCO2…

Answer 24

retaining CO2= increased ETCO2 value