You are on page 1of 19

OROPHARYNGEAL ,

NASOPHARYNGEAL AND NASO


TRACHEAL SUCTIONING

PREPARED BY: JESSICA M. SALDANA, RN., MAN


ORAL OROPHARYNGEAL
Nasopharyngeal Catheter
Nasopharyngeal Catheter
Nasopharyngeal Catheter
PURPOSES
To remove secretions that obstruct the airway
To facilitate ventilation
To obtain secretions for diagnostic purposes
To prevent infection that may result from
accumulated secretions
ASSESSMENT
Assess for clinical signs indicating the need for suctioning:
Restlessness
Gurgling sounds during respirations
Adeventitious sounds when the chest is being
auscultated
Change in mental status
Skin color
Rate and pattern of respirations
Pulse rate and rhythm
Decreased oxygen saturation
PLANNING
Delegation
Oral suctioning using the yankuer suction tube and
oropharyngeal suctioning using a suction catheter can
be deligated to UAP and to the client or family, if
appropriate, since this is not a sterile. The nurse needs
to review the procedure and important points such as
not applying suction during insertion of the tube to
avoid trauma to the mucous membranes. In contrast,
nasopharyngeal and nasotracheal suctioning uses sterile
technique and requires application of knowledge and
problem solving and should be performed by the nurse
or respiratory therapist.
EQUIPMENT
Oral and Nasopharyngeal/Nasotracheal Suctioning
Towel or moisture resistant pad
Portable or wall suction machine with tubing, collection
receptacle, and suction pressure gauge
Sterile disposable container for fluids
Sterile normal saline or water
Goggles or face shield, if approoriate
Moisture-resistant disposable bag
Sputum trap, if specimen is to be collected
EQUIPMENT
Oral and Oropharyngeal Suctioning
Yankauer suction catheter or suction catheter kit
Clean gloves

Nasopharyngeal or Nasotracheal Suctioning


Sterile gloves
Sterile suctrion catheter kit (# 12 to # 18 Fr. For adults, # 8 to
# 10 Fr. For children, and # 5 to # 8 for infants)
Water soluble lubricant
Y- connector
IMPLEMENTATION
Performance
1. Prior to performing the procedure, introduce self and verify
the clients identity using agency protocol. Explain to the
client what you are going to do, why it is necessary, and how
he or she can cooperate. Inform the client that suctioning will
relieve breathing difficulty and that the procedure is painless
but may be uncomfortable and stimulate the cough, gag, or
sneeze reflex. RATIONALE: Knowing that the procedure
will relieve breathing problems is often reassuring and
enlists the clients cooperation.
2. Perform hand hygiene and observe other appropriate infection
control procedures.
3. Provide for client privacy
Yankauer suction catheter
IMPLEMENTATION
4. Prepare the client
Position a conscious person who has a functional gag reflex in semi
Fowlers position with the head turned to one side for oral suctioning or
with the neck hyper extended for nasal suctioning. RATIONALE: These
positions facilitate the insertion of catheter and help prevent
aspiration of the secretions
Position an unconscious client in the lateral position, facing you.
RATIONALE: This position allows the tongue to fall forward, so
that it will not obstruct the catheter on insertion. The lateral position
also facilitates drainage of secretions from the pharynx and prevents
the possibility of aspiration.
Place the towel or moisture resistant pad over the pillow or under the chin
IMPLEMENTATION
5. Prepare the equipment.
Set the pressure on the suction gauge, and turn on the suction.
Many suction devices are calibrated to three pressure ranges.
Wall unit:
Adult: 100 to 120 mm.Hg.
Child: 95 to 110 mm.Hg.
Infant: 50 to 95 mm.Hg.
Portable unit:
Adult: 10 to 15 mm. Hg.
Child: 5 to 10 mm. Hg.
Infant: 2 to 5 mm. Hg.
IMPLEMENTATION
For Oral and Oropharyngeal Suction
Moisten the tip of the Yankauer or suction catheter with sterile
saline water or saline. RATIONALE: This reduces friction and
eases insertion.
Pull the tongue forward, if necessary, using gauze.
Do not apply suction. RATIONALE: Applying suction during
insertion causes trauma to th emucous membrane.
Advance the catheter about 10 to 15 cm. ( 4 to 6 in.) along one
side of the mouth into the oropharynx. RATIONALE:
Directing the catheter along the sides prevents gagging.
It maybe necessary during the oropharyngeal suctioning to apply
suction to secretions that collect in the vestibule of the mouth
and beneath the tongue.
IMPLEMENTATION
For Nasopharyngeal and Nasotracheal Suction
Open the lubricant if performing nasopharyngeal/nasotrecheal suctioning
Open the sterile suction package
a. Set up the container, touching only the outside.
b. Pour sterile water or saline into the container.
c. Put on sterile gloves, or put on a non sterile gloves on the non dominant
hand. RATIONALE: The sterile glove hand maintains the sterility of the
suction catheter, and the un sterile gloves prevents the transmission of
microorganism to the nurse.
With your sterile gloved hand, pick up the catheter and attach it to the
suction unit.
6. Make an approximate depth of insertion of the catheter and test the
equipment.
Measure the distance betwteen the tip of the clients nose and the earlobe, or
about 13 cm ( 5 in.) for an adult.
Mark the position on the tube with the fingers of the sterile gloved hand.
IMPLEMENTATION
Test the pressure of the suction and the patency of the catheter by applying
your sterile gloved finger or thumb to the port or open branch of the Y-
connector to create suction.
7. Lubricate and introduce the catheter.
Lubricate the catheter tip with saline water, or sterile water or water soluble
lubricant. RATIONALE: This reduces friction and eases insertion.
Remove oxygen with the non dominant hand, and if appropriate.
Without applying suction, inset the catheter the pre measured or
recommend distance into their naris and advance it along the floor of the
nasal cavity. RATIONALE: This avoids the nasal turbinates.
8. Perform suctioning.
Apply your finger to the suction control port to start suction, and gently
rotate the catheter. RATIONALE: Gentle rotation of the catheter ensures
that all surfaces are reached and prevents trauma to any one area of the
respiratory mucosa due to prolonged suction.
Apply suction for 5 to 10 seconds while slowly withdrawing the catheter ,
then remove the finger from the control and remove the catheter .
IMPLEMENTATION
9. Rinse the catheter and repeat suctioning as
above.
Rinse and flush the catheter and tubing with
sterile water or saline.
Relubricate the catheter, and repeat suctioning
until the air passage is clear.
Allow sufficient time between each suction
THE END