endobj
The catheter is connected to the breathing tube and contained within a sterile plastic bag. Coarse rhonchi present over anterior upper airway. endobj
Suctioning is indicated when the patient is unable to clear secretions and/or when there is audible or visible evidence of secretions in the large/central airways that persist in spite of the patients best cough effort. Vital signs obtained prior to procedure were heart rate 88 in regular rhythm, respiratory rate 28/minute, and O2 sat 88% on room air. 11 0 obj
<>
17 0 obj
Replace the oxygen delivery device using your nondominant hand, if appropriate, and have the patient take several deep breaths.
Allow 30 seconds to 1 minute between passes to allow reoxygenation and reventilation. Adjust the bed to a comfortable working height and lower the side rail closest to you. Withdrawal or Withholding of Life Support. for an image of extension tubing attached to a suction canister that is connected to a wall suctioning source. The following ranges are appropriate pressure according to the patients age: Use the checklist below to review the steps for completion of Oropharyngeal or Nasopharyngeal Suctioning.. 4 0 obj 4 0 obj During suctioning, a small catheter or tube is inserted into the breathing tube. Set it up on the work surface and fill with sterile saline using sterile technique. Suctioning is uncomfortable but it only lasts a few seconds. endobj q ?CU 14 0 obj stream For nasopharyngeal suctioning, gently insert the catheter through the naris and along the floor of the nostril toward the trachea. 0 %PDF-1.7 % {R5hf33Px~A,y+^gTge 13 0 obj The ventilator will often alarm during suctioning. Place a towel or waterproof pad across the patients chest. Patient complaining of not being able to cough up secretions. If unconscious, place the patient in the lateral position, facing you. Remove the oxygen delivery device, if appropriate. (+PF4y1i2Z =( 273 0 obj <>stream Ensure the patients privacy and dignity. d1AGCd2X.p)LV884}LuiE 0_wc2js'S8 RT)uxSL`B$*+:b:>&2Ne@"q5=&- 29,IPg>ERS Nsek@@P'g"tR9~1;eks[DJo#AL}_}>}I>L&X2x?i6iGoS,cHa U1ciPz^2j^7{ Ol=9f"B;D 6xp"V*2e \_rg)Hwg:?;w7> Remove the glove from the nondominant hand and dispose of gloves, catheter, and the container with solution in the appropriate receptacle. Assist the patient to a comfortable position. Remove face shield or goggles and mask; perform hand hygiene. When suctioning is completed, remove gloves from the dominant hand over the coiled catheter, pulling them off inside out. Place a small amount of water-soluble lubricant on the sterile field, taking care to avoid touching the sterile field with the lubricant package. 15 0 obj 16 0 obj (2010). endobj Put on a face shield or goggles and mask. Pressure should not exceed 150 mm Hg because higher pressures have been shown to cause trauma, hypoxemia, and atelectasis. Put on a clean glove and occlude the end of the connection tubing to check suction pressure. Order was obtained to suction via the nasopharyngeal route. Suction only on withdrawal and do not suction for more than 10 to 15 seconds at a time to minimize tissue trauma. With the dominant gloved hand, pick up the sterile suction catheter. <> AARC clinical practice guideline: Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Want to adapt books like this? Lippincott procedures. This actually helps to bring more of the secretions forward. Coarse rhonchi continued to be present over anterior upper airway but no cyanosis present.
Post-procedure vital signs were heart rate 78 in regular rhythm, respiratory rate 18/minute, and O2 sat 94% on room air. In many agencies, Yankauer suctioning can be delegated to trained assistive personnel if the patient is stable, but the nurse is responsible for assessing and documenting the patients respiratory status.
endstream endobj startxref <> endobj Follow agency policy regarding setting suction pressure. Post-procedure vital signs were heart rate 78 in regular rhythm, respiratory rate 18/minute, and O2 sat 94% on room air. The suction (or vacuum) is applied to the catheter as the tube is removed. for an image of a Yankauer device. {aJlA=)M/M2#B>f vu5h'Bf"KH !3)`_6Hx:1+BG]DD4"#PT!,cfya[S3B!~_3i4c|]QgW429JnL/tv)(1$*IWv;ZZy8MJe3n,$C 7 sqK],@ME#cR< M#C03F4U2y3}ZjBEhAF%AcaDFF'5:sg&2Mn5,Yt(h'bEI3WD``1=+#AjCsPxVxF@2=# Px8 .1NK}&.P#6tlf&Ayu97rs&3m8Q{o>F&[9ja@p}8?+]s S}P{a*Tw_W$R7 0-~@9,@$i>ENgJ@R ! Vital signs obtained prior to procedure were heart rate 88 in regular rhythm, respiratory rate 28/minute, and O2 sat 88% on room air. Wrap the suction catheter around your dominant hand between attempts: Repeat the procedure up to three times until gurgling or bubbling sounds stop and respirations are quiet. See Figure 22.6[3]for an image of a sterile suction catheter. Don additional PPE. endobj <>>> R (*MDKE'?ua* 7B0xNE_0Cxx~/~,GKnnYEb8T|(2:P.J'KmEVY:Q1M.0c3TD(%YU. Raise the bed rail and place the bed in the lowest position. Hy]Ei ]/xvX4fR*#)%*8Vj:u|TJ-wPIQ~ See Figure 22.7[4]for an image of extension tubing attached to a suction canister that is connected to a wall suctioning source. Please seethe COVID-19 section of our website for up-to-date information. <> 2 0 obj Report any concerns according to agency policy. <> <>
&_kjpD2ZP U&I_c31j$Z62vD&8GN \"Z^r_W gp)[wxnYT vT].aOr#WcwrL*L((C$:5 f6yIn[` "orz69y+zlVrOhX4qQ:d?jFn=W@3F~"CIj#2 rFW%@U_nxW_75d-?X8PFcFj>Be!)aE7u$Sd3(V!OBwY <> <>>>/BBox[ 0 0 149.67 74.835] /Matrix[ 0.48106 0 0 0.96212 0 0] /Length 49>> Patient tolerated procedure without difficulties. In the home setting and other community-based settings, maintenance of sterility is not necessary. 2 0 obj Suctioning via the oropharyngeal (mouth) and nasopharyngeal (nasal) routes is performed to remove accumulated saliva, pulmonary secretions, blood, vomitus, and other foreign material from these areas that cannot be removed by the patients spontaneous cough or other less invasive procedures. Pick up the connecting tubing with the nondominant hand and connect the tubing and suction catheter. <> terile gloves for suctioning with sterile suction catheter, t, https://www.aarc.org/wp-content/uploads/2014/08/09.04.1080.pdf, https://opentextbc.ca/clinicalskills/chapter/5-7-oral-suctioning/, http://www.rcjournal.com/cpgs/pdf/06.10.0758.pdf, Next: 22.5 Checklist for Tracheostomy Suctioning and Sample Documentation, Creative Commons Attribution 4.0 International License, Chest auscultation of coarse, gurgling breath sounds, rhonchi, or diminished breath sounds, Reported feeling of secretions in the chest, Suspected aspiration of gastric or upper airway secretions, Clinically apparent increased work of breathing, Gather supplies: Yankauer or suction catheter, suction machine or wall suction device, suction canister, connecting tubing, pulse oximeter, stethoscope, PPE (e.g., mask, goggles or face shield, nonsterile gloves), s. Check the room for transmission-based precautions. e5n%L#Bx)NDF>{ ck?rBLX9y)dZz|j,}y./[p={}_~V7LC-p3p*e\Ejha stream Flush the catheter with saline.
Insert the catheter. Turn off the suction. We may need to give the patient a medication to relax their breathing. endobj <> -@a(&9BKbb{+?Dr {y$>!MV3=wm,$j!TH!b. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Document the procedure and related assessment findings. How do I prevent the spread of infection? <>/XObject<>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endobj Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time. Nasopharyngeal suctioning removes secretions from the nasal cavity, pharynx, and throat by inserting a flexible, soft suction catheter through the nares. 9 0 obj Order was obtained to suction via the nasopharyngeal route. "wxN*F1Mu#fA.NRxyY}/M@ZXE-$dhXF-R\6,qDznqHU "5"J3"8Y=-"H+tmZ_|Ar9?[? endobj 210 0 obj <> endobj endobj ?[(NLDH|m?n,g>l4')XY'xyHJGdt?-\=/__{ot~Jw !#1,?1/E,#Ut')!`AZS? This allows us to quickly suction a patient, without interrupting the breathing machine. endstream endstream Facebook Twitter Youtube Instagram LinkedIn.
3 0 obj A small rubber tube called a "nasal trumpet" may be left inside one side of the nose to make it easier to slide the suction catheter into the airway and to reduce the irritation caused by inserting the catheter. Q?%LpH ]A'w <> 12 0 obj Encourage the patient to take several deep breaths. k2zl97TB8rmM4gi\. endobj However, routine suctioning does require a provider order. <> Reassess the patients respiratory status, including respiratory rate, effort, oxygen saturation, and lung sounds. Where can I get help for myself or my family. Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take. Do not apply suction as the catheter is inserted. <> Suctioning is sometimes done when the patient does not have a breathing tube. Remove the supplemental oxygen placed for suctioning, if appropriate. For oropharyngeal suctioning, a device called a Yankauer suction tip is typically used for suctioning mouth secretions. ,SVP'%9Sz[J:=K! The nondominant hand is considered clean rather than sterile and will control the suction valve on the catheter. % <> Adjust the suction to the appropriate pressure: Adults and adolescents: no more than 150 mm Hg. Assess the effectiveness of suctioning by listening to lung sounds and repeat, as needed, and according to the patients tolerance. 'uG6mT+3SV&edHN^"h~q?]%^ao55Zx }mK[d%^ajQE(TVT~>xfZ`@]Yx^xwc5y{6LSbVMM~$ . Nursing Skills by Open Resources for Nursing (Open RN) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. endobj Perform oral hygiene on the patient after suctioning. %%EOF % 1 0 obj Lung sounds clear and no cyanosis present. See Figure 22.5[2]for an image of a Yankauer device. endobj A Yankauer device is rigid and has several holes for suctioning secretions that are commonly thick and difficult for the patient to clear. hb```e`` ,@9Oo?KO V%@ZV(+,a`K`` 0u@R5X, 8?BMG1\v{OvZF-FOYa}"@+ex. Ba?-_\w!6aFr?y_ xjk4'JF_F{Za4cb =oe4=_6p[=NB)yCD#(B43(~l}Id bkGq*6i"56n_|}zYwLV|FJ0 ve$5ATFr`x40;O#Rozv+65tX. %PDF-1.5 A small amount of clear, white, thick sputum was obtained. Oronasopharyngeal suctioning. hbbd```b``S@$)d A$4X d6lB49 "9A$1fgH@.l#e"SbwkAN{mal8- endobj <> (2020). 1 0 obj The dominant hand will manipulate the catheter and must remain sterile. <>>> AARC clinical practice guideline: Nasotracheal suctioning - 2004 revision & update. No cyanosis present. xZn7}7S[A\E>}X-@R[ywmP;rHiGX6C}a%y y}u~)S8SU:r[B,]i In many agencies, Yankauer suctioning can be delegated to trained assistive personnel if the patient is stable, but the nurse is responsible for assessing and documenting the patients respiratory status. Coarse rhonchi present over anterior upper airway.
endobj Often, the patient will cough during the procedure. Dr. Smith notified and a STAT order was received for a chest X-ray and to call with results. Procedure was stopped and emergency assistance was requested from the respiratory therapist. Patient complaining of not being able to cough up secretions. x\[o~G{QDR"@^6dI8(p\k)3h"S'd#gm}3)[vRUm:I[gW-\z;>aQ Need for suctioning is evidenced by one or more of the following: In emergent situations, a provider order is not necessary for suctioning to maintain a patients airway. After the tube has been cleaned out, the patient will usually find it easier to breathe. Carefully remove the sterile container, touching only the outside surface. Learn more about how Pressbooks supports open practices. endobj 8 0 obj Don sterile gloves. Procedure explained to the patient. :}P.XT5aWbo^?_#lif'$w"ICKH&"{CV>OKheF.%86? Hold the catheter between your thumb and forefinger. 'o28ah{q^2IT% j1FiPPY AEY.Ujddp,>{BQ&m&,~&tm d2c0E,6i^ %PDF-1.5 3 0 obj for an image of a sterile suction catheter. American Association for Respiratory Care. Roll the catheter between your fingers to help advance it. Extension tubing is used to attach the Yankauer or suction catheter device to a suction canister that is attached to wall suction or a portable suction source. endobj The amount of suction is set to an appropriate pressure according to the patients age. Apply suction by intermittently occluding the suction valve on the catheter with the thumb of your nondominant hand and continuously rotate the catheter as it is being withdrawn. The patient may feel like his or her breath is being taken away. American Association for Respiratory Care. 5 0 obj No cyanosis present. Advance the catheter approximately 5 to 6 inches to reach the pharynx. Suction of secretions through the mouth, often using a Yankauer device. 8Q!" HA <> /Image17 Do Q For oropharyngeal suctioning, insert the catheter through the mouth, along the side of the mouth toward the trachea. Apply lubricant to the first 2 to 3 inches of the catheter, using the lubricant that was placed on the sterile field. 2.8 Functional Health and Activities of Daily Living, 2.11 Checklist for Obtaining a Health History, Chapter Resources A: Sample Health History Form, 3.6 Supplementary Video of Blood Pressure Assessment, 4.5 Checklist for Hand Hygiene with Soap and Water, 4.6 Checklist for Hand Hygiene with Alcohol-Based Hand Sanitizer, 4.7 Checklist for Personal Protective Equipment (PPE), 4.8 Checklist for Applying and Removing Sterile Gloves, 6.12 Checklist for Neurological Assessment, 7.1 Head and Neck Assessment Introduction, 7.3 Common Conditions of the Head and Neck, 7.6 Checklist for Head and Neck Assessment, 7.7 Supplementary Video on Head and Neck Assessment, 8.6 Supplementary Video on Eye Assessment, 9.1 Cardiovascular Assessment Introduction, 9.5 Checklist for Cardiovascular Assessment, 9.6 Supplementary Videos on Cardiovascular Assessment, 10.5 Checklist for Respiratory Assessment, 10.6 Supplementary Videos on Respiratory Assessment, 11.4 Nursing Process Related to Oxygen Therapy, 11.7 Supplementary Videos on Oxygen Therapy, 12.3 Gastrointestinal and Genitourinary Assessment, 12.6 Supplementary Video on Abdominal Assessment, 13.1 Musculoskeletal Assessment Introduction, 13.6 Checklist for Musculoskeletal Assessment, 14.1 Integumentary Assessment Introduction, 14.6 Checklist for Integumentary Assessment, 15.1 Administration of Enteral Medications Introduction, 15.2 Basic Concepts of Administering Medications, 15.3 Assessments Related to Medication Administration, 15.4 Checklist for Oral Medication Administration, 15.5 Checklist for Rectal Medication Administration, 15.6 Checklist for Enteral Tube Medication Administration, 16.1 Administration of Medications Via Other Routes Introduction, 16.3 Checklist for Transdermal, Eye, Ear, Inhalation, and Vaginal Routes Medication Administration, 17.1 Enteral Tube Management Introduction, 17.3 Assessments Related to Enteral Tubes, 17.5 Checklist for NG Tube Enteral Feeding By Gravity with Irrigation, 18.1 Administration of Parenteral Medications Introduction, 18.3 Evidence-Based Practices for Injections, 18.4 Administering Intradermal Medications, 18.5 Administering Subcutaneous Medications, 18.6 Administering Intramuscular Medications, 18.8 Checklists for Parenteral Medication Administration, 19.8 Checklist for Blood Glucose Monitoring, 19.9 Checklist for Obtaining a Nasal Swab, 19.10 Checklist for Oropharyngeal Testing, 20.8 Checklist for Simple Dressing Change, 20.10 Checklist for Intermittent Suture Removal, 20.12 Checklist for Wound Cleansing, Irrigation, and Packing, 21.1 Facilitation of Elimination Introduction, 21.4 Inserting and Managing Indwelling Urinary Catheters, 21.5 Obtaining Urine Specimen for Culture, 21.6 Removing an Indwelling Urinary Catheter, 21.8 Applying the Nursing Process to Catheterization, 21.10 Checklist for Foley Catheter Insertion (Male), 21.11 Checklist for Foley Catheter Insertion (Female), 21.12 Checklist for Obtaining a Urine Specimen from a Foley Catheter, 21.14 Checklist for Straight Catheterization Female/Male, 21.15 Checklist for Ostomy Appliance Change, 22.1 Tracheostomy Care & Suctioning Introduction, 22.2 Basic Concepts Related to Suctioning, 22.3 Assessments Related to Airway Suctioning, 22.4 Oropharyngeal and Nasopharyngeal Suctioning Checklist & Sample Documentation, 22.5 Checklist for Tracheostomy Suctioning and Sample Documentation, 22.6 Checklist for Tracheostomy Care and Sample Documentation, 23.5 Checklist for Primary IV Solution Administration, 23.6 Checklist for Secondary IV Solution Administration, 23.9 Supplementary Videos Related to IV Therapy, Chapter 15 (Administration of Enteral Medications), Chapter 16 (Administration of Medications via Other Routes), Chapter 18 (Administration of Parenteral Medications), Chapter 22 (Tracheostomy Care & Suctioning), Appendix A - Hand Hygiene and Vital Signs Checklists, Appendix C - Head-to-Toe Assessment Checklist. If conscious, place the patient in a semi-Fowlers position. After first pass of suctioning, patient began coughing uncontrollably. 6 0 obj Occlude the suction valve on the catheter to check for suction. stream Moisten the catheter by dipping it into the container of sterile saline. Open the sterile suction package using aseptic technique.
Confirm patient ID using two patient identifiers (e.g., name and date of birth). Procedure explained to the patient. q Place the connecting tubing in a convenient location (e.g., at the head of the bed). Increase the patients supplemental oxygen level or apply supplemental oxygen per facility policy or primary care provider order. 150.8 0 0 75.993 0 -1.1585 cm 7 0 obj How will children respond to critical illness? Ensure safety measures when leaving the room: BED: Low and locked (in lowest position and brakes on), ROOM: Risk-free for falls (scan room and clear any obstacles).
17 0 obj
Replace the oxygen delivery device using your nondominant hand, if appropriate, and have the patient take several deep breaths. Allow 30 seconds to 1 minute between passes to allow reoxygenation and reventilation. Adjust the bed to a comfortable working height and lower the side rail closest to you. Withdrawal or Withholding of Life Support. for an image of extension tubing attached to a suction canister that is connected to a wall suctioning source. The following ranges are appropriate pressure according to the patients age: Use the checklist below to review the steps for completion of Oropharyngeal or Nasopharyngeal Suctioning.. 4 0 obj 4 0 obj During suctioning, a small catheter or tube is inserted into the breathing tube. Set it up on the work surface and fill with sterile saline using sterile technique. Suctioning is uncomfortable but it only lasts a few seconds. endobj q ?CU 14 0 obj stream For nasopharyngeal suctioning, gently insert the catheter through the naris and along the floor of the nostril toward the trachea. 0 %PDF-1.7 % {R5hf33Px~A,y+^gTge 13 0 obj The ventilator will often alarm during suctioning. Place a towel or waterproof pad across the patients chest. Patient complaining of not being able to cough up secretions. If unconscious, place the patient in the lateral position, facing you. Remove the oxygen delivery device, if appropriate. (+PF4y1i2Z =( 273 0 obj <>stream Ensure the patients privacy and dignity. d1AGCd2X.p)LV884}LuiE 0_wc2js'S8 RT)uxSL`B$*+:b:>&2Ne@"q5=&- 29,IPg>ERS Nsek@@P'g"tR9~1;eks[DJo#AL}_}>}I>L&X2x?i6iGoS,cHa U1ciPz^2j^7{ Ol=9f"B;D 6xp"V*2e \_rg)Hwg:?;w7> Remove the glove from the nondominant hand and dispose of gloves, catheter, and the container with solution in the appropriate receptacle. Assist the patient to a comfortable position. Remove face shield or goggles and mask; perform hand hygiene. When suctioning is completed, remove gloves from the dominant hand over the coiled catheter, pulling them off inside out. Place a small amount of water-soluble lubricant on the sterile field, taking care to avoid touching the sterile field with the lubricant package. 15 0 obj 16 0 obj (2010). endobj Put on a face shield or goggles and mask. Pressure should not exceed 150 mm Hg because higher pressures have been shown to cause trauma, hypoxemia, and atelectasis. Put on a clean glove and occlude the end of the connection tubing to check suction pressure. Order was obtained to suction via the nasopharyngeal route. Suction only on withdrawal and do not suction for more than 10 to 15 seconds at a time to minimize tissue trauma. With the dominant gloved hand, pick up the sterile suction catheter. <> AARC clinical practice guideline: Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Want to adapt books like this? Lippincott procedures. This actually helps to bring more of the secretions forward. Coarse rhonchi continued to be present over anterior upper airway but no cyanosis present.
Post-procedure vital signs were heart rate 78 in regular rhythm, respiratory rate 18/minute, and O2 sat 94% on room air. In many agencies, Yankauer suctioning can be delegated to trained assistive personnel if the patient is stable, but the nurse is responsible for assessing and documenting the patients respiratory status.
endstream endobj startxref <> endobj Follow agency policy regarding setting suction pressure. Post-procedure vital signs were heart rate 78 in regular rhythm, respiratory rate 18/minute, and O2 sat 94% on room air. The suction (or vacuum) is applied to the catheter as the tube is removed. for an image of a Yankauer device. {aJlA=)M/M2#B>f vu5h'Bf"KH !3)`_6Hx:1+BG]DD4"#PT!,cfya[S3B!~_3i4c|]QgW429JnL/tv)(1$*IWv;ZZy8MJe3n,$C 7 sqK],@ME#cR< M#C03F4U2y3}ZjBEhAF%AcaDFF'5:sg&2Mn5,Yt(h'bEI3WD``1=+#AjCsPxVxF@2=# Px8 .1NK}&.P#6tlf&Ayu97rs&3m8Q{o>F&[9ja@p}8?+]s S}P{a*Tw_W$R7 0-~@9,@$i>ENgJ@R ! Vital signs obtained prior to procedure were heart rate 88 in regular rhythm, respiratory rate 28/minute, and O2 sat 88% on room air. Wrap the suction catheter around your dominant hand between attempts: Repeat the procedure up to three times until gurgling or bubbling sounds stop and respirations are quiet. See Figure 22.6[3]for an image of a sterile suction catheter. Don additional PPE. endobj <>>> R (*MDKE'?ua* 7B0xNE_0Cxx~/~,GKnnYEb8T|(2:P.J'KmEVY:Q1M.0c3TD(%YU. Raise the bed rail and place the bed in the lowest position. Hy]Ei ]/xvX4fR*#)%*8Vj:u|TJ-wPIQ~ See Figure 22.7[4]for an image of extension tubing attached to a suction canister that is connected to a wall suctioning source. Please seethe COVID-19 section of our website for up-to-date information. <> 2 0 obj Report any concerns according to agency policy. <> <>
&_kjpD2ZP U&I_c31j$Z62vD&8GN \"Z^r_W gp)[wxnYT vT].aOr#WcwrL*L((C$:5 f6yIn[` "orz69y+zlVrOhX4qQ:d?jFn=W@3F~"CIj#2 rFW%@U_nxW_75d-?X8PFcFj>Be!)aE7u$Sd3(V!OBwY <> <>>>/BBox[ 0 0 149.67 74.835] /Matrix[ 0.48106 0 0 0.96212 0 0] /Length 49>> Patient tolerated procedure without difficulties. In the home setting and other community-based settings, maintenance of sterility is not necessary. 2 0 obj Suctioning via the oropharyngeal (mouth) and nasopharyngeal (nasal) routes is performed to remove accumulated saliva, pulmonary secretions, blood, vomitus, and other foreign material from these areas that cannot be removed by the patients spontaneous cough or other less invasive procedures. Pick up the connecting tubing with the nondominant hand and connect the tubing and suction catheter. <> terile gloves for suctioning with sterile suction catheter, t, https://www.aarc.org/wp-content/uploads/2014/08/09.04.1080.pdf, https://opentextbc.ca/clinicalskills/chapter/5-7-oral-suctioning/, http://www.rcjournal.com/cpgs/pdf/06.10.0758.pdf, Next: 22.5 Checklist for Tracheostomy Suctioning and Sample Documentation, Creative Commons Attribution 4.0 International License, Chest auscultation of coarse, gurgling breath sounds, rhonchi, or diminished breath sounds, Reported feeling of secretions in the chest, Suspected aspiration of gastric or upper airway secretions, Clinically apparent increased work of breathing, Gather supplies: Yankauer or suction catheter, suction machine or wall suction device, suction canister, connecting tubing, pulse oximeter, stethoscope, PPE (e.g., mask, goggles or face shield, nonsterile gloves), s. Check the room for transmission-based precautions. e5n%L#Bx)NDF>{ ck?rBLX9y)dZz|j,}y./[p={}_~V7LC-p3p*e\Ejha stream Flush the catheter with saline.
Insert the catheter. Turn off the suction. We may need to give the patient a medication to relax their breathing. endobj <> -@a(&9BKbb{+?Dr {y$>!MV3=wm,$j!TH!b. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Document the procedure and related assessment findings. How do I prevent the spread of infection? <>/XObject<>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> endobj Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time. Nasopharyngeal suctioning removes secretions from the nasal cavity, pharynx, and throat by inserting a flexible, soft suction catheter through the nares. 9 0 obj Order was obtained to suction via the nasopharyngeal route. "wxN*F1Mu#fA.NRxyY}/M@ZXE-$dhXF-R\6,qDznqHU "5"J3"8Y=-"H+tmZ_|Ar9?[? endobj 210 0 obj <> endobj endobj ?[(NLDH|m?n,g>l4')XY'xyHJGdt?-\=/__{ot~Jw !#1,?1/E,#Ut')!`AZS? This allows us to quickly suction a patient, without interrupting the breathing machine. endstream endstream Facebook Twitter Youtube Instagram LinkedIn.
3 0 obj A small rubber tube called a "nasal trumpet" may be left inside one side of the nose to make it easier to slide the suction catheter into the airway and to reduce the irritation caused by inserting the catheter. Q?%LpH ]A'w <> 12 0 obj Encourage the patient to take several deep breaths. k2zl97TB8rmM4gi\. endobj However, routine suctioning does require a provider order. <> Reassess the patients respiratory status, including respiratory rate, effort, oxygen saturation, and lung sounds. Where can I get help for myself or my family. Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take. Do not apply suction as the catheter is inserted. <> Suctioning is sometimes done when the patient does not have a breathing tube. Remove the supplemental oxygen placed for suctioning, if appropriate. For oropharyngeal suctioning, a device called a Yankauer suction tip is typically used for suctioning mouth secretions. ,SVP'%9Sz[J:=K! The nondominant hand is considered clean rather than sterile and will control the suction valve on the catheter. % <> Adjust the suction to the appropriate pressure: Adults and adolescents: no more than 150 mm Hg. Assess the effectiveness of suctioning by listening to lung sounds and repeat, as needed, and according to the patients tolerance. 'uG6mT+3SV&edHN^"h~q?]%^ao55Zx }mK[d%^ajQE(TVT~>xfZ`@]Yx^xwc5y{6LSbVMM~$ . Nursing Skills by Open Resources for Nursing (Open RN) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. endobj Perform oral hygiene on the patient after suctioning. %%EOF % 1 0 obj Lung sounds clear and no cyanosis present. See Figure 22.5[2]for an image of a Yankauer device. endobj A Yankauer device is rigid and has several holes for suctioning secretions that are commonly thick and difficult for the patient to clear. hb```e`` ,@9Oo?KO V%@ZV(+,a`K`` 0u@R5X, 8?BMG1\v{OvZF-FOYa}"@+ex. Ba?-_\w!6aFr?y_ xjk4'JF_F{Za4cb =oe4=_6p[=NB)yCD#(B43(~l}Id bkGq*6i"56n_|}zYwLV|FJ0 ve$5ATFr`x40;O#Rozv+65tX. %PDF-1.5 A small amount of clear, white, thick sputum was obtained. Oronasopharyngeal suctioning. hbbd```b``S@$)d A$4X d6lB49 "9A$1fgH@.l#e"SbwkAN{mal8- endobj <> (2020). 1 0 obj The dominant hand will manipulate the catheter and must remain sterile. <>>> AARC clinical practice guideline: Nasotracheal suctioning - 2004 revision & update. No cyanosis present. xZn7}7S[A\E>}X-@R[ywmP;rHiGX6C}a%y y}u~)S8SU:r[B,]i In many agencies, Yankauer suctioning can be delegated to trained assistive personnel if the patient is stable, but the nurse is responsible for assessing and documenting the patients respiratory status. Coarse rhonchi present over anterior upper airway.
endobj Often, the patient will cough during the procedure. Dr. Smith notified and a STAT order was received for a chest X-ray and to call with results. Procedure was stopped and emergency assistance was requested from the respiratory therapist. Patient complaining of not being able to cough up secretions. x\[o~G{QDR"@^6dI8(p\k)3h"S'd#gm}3)[vRUm:I[gW-\z;>aQ Need for suctioning is evidenced by one or more of the following: In emergent situations, a provider order is not necessary for suctioning to maintain a patients airway. After the tube has been cleaned out, the patient will usually find it easier to breathe. Carefully remove the sterile container, touching only the outside surface. Learn more about how Pressbooks supports open practices. endobj 8 0 obj Don sterile gloves. Procedure explained to the patient. :}P.XT5aWbo^?_#lif'$w"ICKH&"{CV>OKheF.%86? Hold the catheter between your thumb and forefinger. 'o28ah{q^2IT% j1FiPPY AEY.Ujddp,>{BQ&m&,~&tm d2c0E,6i^ %PDF-1.5 3 0 obj for an image of a sterile suction catheter. American Association for Respiratory Care. Roll the catheter between your fingers to help advance it. Extension tubing is used to attach the Yankauer or suction catheter device to a suction canister that is attached to wall suction or a portable suction source. endobj The amount of suction is set to an appropriate pressure according to the patients age. Apply suction by intermittently occluding the suction valve on the catheter with the thumb of your nondominant hand and continuously rotate the catheter as it is being withdrawn. The patient may feel like his or her breath is being taken away. American Association for Respiratory Care. 5 0 obj No cyanosis present. Advance the catheter approximately 5 to 6 inches to reach the pharynx. Suction of secretions through the mouth, often using a Yankauer device. 8Q!" HA <> /Image17 Do Q For oropharyngeal suctioning, insert the catheter through the mouth, along the side of the mouth toward the trachea. Apply lubricant to the first 2 to 3 inches of the catheter, using the lubricant that was placed on the sterile field. 2.8 Functional Health and Activities of Daily Living, 2.11 Checklist for Obtaining a Health History, Chapter Resources A: Sample Health History Form, 3.6 Supplementary Video of Blood Pressure Assessment, 4.5 Checklist for Hand Hygiene with Soap and Water, 4.6 Checklist for Hand Hygiene with Alcohol-Based Hand Sanitizer, 4.7 Checklist for Personal Protective Equipment (PPE), 4.8 Checklist for Applying and Removing Sterile Gloves, 6.12 Checklist for Neurological Assessment, 7.1 Head and Neck Assessment Introduction, 7.3 Common Conditions of the Head and Neck, 7.6 Checklist for Head and Neck Assessment, 7.7 Supplementary Video on Head and Neck Assessment, 8.6 Supplementary Video on Eye Assessment, 9.1 Cardiovascular Assessment Introduction, 9.5 Checklist for Cardiovascular Assessment, 9.6 Supplementary Videos on Cardiovascular Assessment, 10.5 Checklist for Respiratory Assessment, 10.6 Supplementary Videos on Respiratory Assessment, 11.4 Nursing Process Related to Oxygen Therapy, 11.7 Supplementary Videos on Oxygen Therapy, 12.3 Gastrointestinal and Genitourinary Assessment, 12.6 Supplementary Video on Abdominal Assessment, 13.1 Musculoskeletal Assessment Introduction, 13.6 Checklist for Musculoskeletal Assessment, 14.1 Integumentary Assessment Introduction, 14.6 Checklist for Integumentary Assessment, 15.1 Administration of Enteral Medications Introduction, 15.2 Basic Concepts of Administering Medications, 15.3 Assessments Related to Medication Administration, 15.4 Checklist for Oral Medication Administration, 15.5 Checklist for Rectal Medication Administration, 15.6 Checklist for Enteral Tube Medication Administration, 16.1 Administration of Medications Via Other Routes Introduction, 16.3 Checklist for Transdermal, Eye, Ear, Inhalation, and Vaginal Routes Medication Administration, 17.1 Enteral Tube Management Introduction, 17.3 Assessments Related to Enteral Tubes, 17.5 Checklist for NG Tube Enteral Feeding By Gravity with Irrigation, 18.1 Administration of Parenteral Medications Introduction, 18.3 Evidence-Based Practices for Injections, 18.4 Administering Intradermal Medications, 18.5 Administering Subcutaneous Medications, 18.6 Administering Intramuscular Medications, 18.8 Checklists for Parenteral Medication Administration, 19.8 Checklist for Blood Glucose Monitoring, 19.9 Checklist for Obtaining a Nasal Swab, 19.10 Checklist for Oropharyngeal Testing, 20.8 Checklist for Simple Dressing Change, 20.10 Checklist for Intermittent Suture Removal, 20.12 Checklist for Wound Cleansing, Irrigation, and Packing, 21.1 Facilitation of Elimination Introduction, 21.4 Inserting and Managing Indwelling Urinary Catheters, 21.5 Obtaining Urine Specimen for Culture, 21.6 Removing an Indwelling Urinary Catheter, 21.8 Applying the Nursing Process to Catheterization, 21.10 Checklist for Foley Catheter Insertion (Male), 21.11 Checklist for Foley Catheter Insertion (Female), 21.12 Checklist for Obtaining a Urine Specimen from a Foley Catheter, 21.14 Checklist for Straight Catheterization Female/Male, 21.15 Checklist for Ostomy Appliance Change, 22.1 Tracheostomy Care & Suctioning Introduction, 22.2 Basic Concepts Related to Suctioning, 22.3 Assessments Related to Airway Suctioning, 22.4 Oropharyngeal and Nasopharyngeal Suctioning Checklist & Sample Documentation, 22.5 Checklist for Tracheostomy Suctioning and Sample Documentation, 22.6 Checklist for Tracheostomy Care and Sample Documentation, 23.5 Checklist for Primary IV Solution Administration, 23.6 Checklist for Secondary IV Solution Administration, 23.9 Supplementary Videos Related to IV Therapy, Chapter 15 (Administration of Enteral Medications), Chapter 16 (Administration of Medications via Other Routes), Chapter 18 (Administration of Parenteral Medications), Chapter 22 (Tracheostomy Care & Suctioning), Appendix A - Hand Hygiene and Vital Signs Checklists, Appendix C - Head-to-Toe Assessment Checklist. If conscious, place the patient in a semi-Fowlers position. After first pass of suctioning, patient began coughing uncontrollably. 6 0 obj Occlude the suction valve on the catheter to check for suction. stream Moisten the catheter by dipping it into the container of sterile saline. Open the sterile suction package using aseptic technique.
Confirm patient ID using two patient identifiers (e.g., name and date of birth). Procedure explained to the patient. q Place the connecting tubing in a convenient location (e.g., at the head of the bed). Increase the patients supplemental oxygen level or apply supplemental oxygen per facility policy or primary care provider order. 150.8 0 0 75.993 0 -1.1585 cm 7 0 obj How will children respond to critical illness? Ensure safety measures when leaving the room: BED: Low and locked (in lowest position and brakes on), ROOM: Risk-free for falls (scan room and clear any obstacles).