What are the aims
- to clear secretions
- maintain pt airway
- help ventilation and oxygenation
- reduce WOB
What is suctioning
Removal of secretions by artificial means
What pressure does suctioning use
Applied negative pressure
What is the normal pressure used for suctioning for adults
80-120mmHg
11-16Kpa
What is the normal pressure used for suctioning on paediatric patients
80-100mmHg
normally not above 100
Which patients need might need suctioning
- Increase production of mucus/altered composition of mucus
- CF
- Pneumonia
- COPD
- Post-op
- Intubated patient
- Damaged cilia post intubation and ventilation
- Systemic dehydration
- Primary ciliary dyskinesia
When should suctioning be done
When all other forms of secretion clearance has been tried as it’s invasive
What’s Yankeur sunctioning
Oral suctioning
What does Yankeur sunctioning aid
- Aids expectoration when patient has coughed but can’t get secretions out of mouth
what does Yankeur suctioning trigger and why do we need to be careful
- triggers cough
- careful because it can damage mouth tissue
What state is a patient in to use Nasopharyngeal airways
conscious/semi-conscious
Where is nasopharyngeal airway inserted
Into the nose
Where is nasopharyngeal airway used
when secretions are too low down for oral suction
When don’t you need a nasopharyngeal airway
If the suction is only being done once
When should nasopharyngeal airway be used?
- Visible, audible or palpable secretions
- Decreased O2 sats
- Increased O2 requirements
- Poor cough/inability
- Reduced movement/breath sounds of chest
- Signs of distress
What condition is a patient in for Guedel Guided Suction
- Sedated
- unconscious
How is Guedel Guided Suction done
- Measure from mouth to tip of jaw
- Inserted into mouth
- Keeps tongue out of way
- Inserted into pt mouth upside down, once contacted with back of throat, rotate 180degrees
- Airway positioned when past tongue and against teeth
- Suction catheter passed down airway until cough triggered
What’s the risk of Guedel Guided suction
increases risk of patient gaging and vomiting
When is Endotracheal and trache suctioning used
- pt is on a vent via ET tube
- tracheostomy tube
What kind of circuit does Endotracheal and trache suctioning use
Closed so the pt stays on the vent
What does open circuit suctioning increase the risk of
Infection because the catheter is in contact with our hand and the air
what are contraindications for suctioning
- Base of skull fracture
- Head injuries
- Suspected cerebrospinal fluid leak
- Nasal fracture
- Stridor (obstruction through narrow airway)
- Severe bronchospasm
What are precautions for suctioning
- Tracheooesophageal fistula (abnormal connection between oesophagus and trachea
- Cancer in respiratory tract or high in GI tract
- Recent GI or oesophageal surgery
- Tracheal anastomoses
- Pulmonary Oedema
- Clotting disorder
- Unstable vitals
- High intercranial pressure
- Occluded nasal passage
What are complications that can occur due to suctioning
- Hypoxaemia/Hypoxia
- Atelectasis, especially in infants
- Vasovagal response/bradycardia
- Cardiac arrest
- Epithelial trauma(e.g. haemorrhage, ulceration)
- Introduction of bacteria
- Oral- risk of gag and vomit
- Paroxysmal coughing
- Anxiety to patient
- Hyper/hypotension
- Pneumothorax
- Raised intracranial pressure
