2. LEARNING OBJECTIVES
Sr. no Learning
objectives
domain level criteria
1 Indication of
suctioning.
Cognitive Must know All
2 Explain types of
suctioning.
Cognitive &
Psychomotor
Must know All
3 Explain types of
suctioning
equipments.
Cognitive &
Psychomotor
Must know All
4 Explain precaution
& hazards of
suctioning.
Cognitive &
Psychomotor
Must know All
4. INDICATIONS
• Whenever the secretions are heard in an intubated
patient
• Retained secretions in patient who is unable to
cough
• Unconscious, weak or neurologically impaired
Patient
• Before & during the release of the cuff of
tracheostomy tube.
7. Equipments
• Portable Suction apparatus
• Suction catheters
• Suction trolley:
Sterile lubricating gel
Normal saline
Sterile plastic gloves
Sterile gauze swabs
Sodium bicarbonate
• Manual resuscitation bag
8. Endotracheal suctioning
• Check equipments & make sure
that all necessary equipments are
reachable
• Check monitor.
• Wash your hands
• Inform patient about the
procedure
• Hyperoxygnate with 100% O2 for 3
to 5 breaths with manual
resuscitation bag
• Place the patients neck in
extension
• Lubricate catheter with sterile
saline
• Kink the catheter and then insert
it till the resistance is felt (Carina)
• Pull the catheter slightly out &
release the kink
•Negative suction pressure for Adults: -100
to -120 mmHg
•Negative suction pressure for children : -
80 to -100 mmHg
•Negative suction pressure for Neonates : -
50 to -80 mmHg
•Do no extend the suction time for more
than 15 seconds.
•The patient is allowed to rest for several
seconds & again the procedure is repeated.
•Check the breath sounds & repeat the
procedure if necessary.
•Always check for monitors for O2
saturation & arrythmias.
•Discard the used equipments & wash
hands.
9. Nasopharyngeal suction
• Extend the patient’s neck & the head is tilted
backwards resting on a pillow
• Ask the patient to protrude the tongue if he/she
cooperates.
• Lubricate the catheter & insert it backwards & upwards
untill the resistance is felt.
• Gentle rolling of the catheter at this point allows the
advancement of the catheter into pharynx.
• The catheter should be inserted during inspiration with
mouth open. The aim is to stimulate cough reflex.
• It must be remembered that it is a very unpleasant
experience hence should only be used when absolutely
necessary.
10. • Always observe the patient for signs of Hypoxia
• If patient already has low PaO2, oxygenate the patient or hyperinflate if
patient is intubated
• If the patient is mechanically ventilated, never disconnect the patient for
more than 15 seconds.
• If possible, rotate the head to one side while suctioning to avoid the
aspiration of gastric contents.
• Reconnect the patient immediately to ventilator or oxygen supply after
suctioning.
• Check for deviated nasal septum, nasal polyps or nasal fractures before
nasal suctioning
PRECAUTIONS
11. Hazards of suctioning
• Risk of infection if its not performed under sterile conditions
• Trauma due to incorrect choice of catheter & excessive
negative pressure
• Hypoxia
• Cardiac arrhythmias
• Atelectasis
12. Question
• Indications of suctioning.
• Types of suctioning apparatus.
• Types of catheter used in suctioning.
• Types of suctioning.
• Hazards of suctioning.