Airway Suctioning Provide privacy. Wash hands. Check order. Check chart for COPD, Pneumonia, Dysphagia, Impaired Mobility, etc. Hi. My name is Jennifer. I am your nurse today. Can you tell me your name and DOB? (Check ID band). Great.The doctor has ordered some airway suctioning for you. This will help clear the mucous from your airway and relieve some of your breathing problem. Can you tell me if you have you had any recent surgery; head, chest, or neck trauma, or a bleeding disorder? Do you have any difficulty swallowing? I am just going to raise your bed (HOB semi-fowler’s position 30 – 45 degrees) and check a few things before we get started. Assess for restlessness, pale skin color, accessory muscle use, ↑ B/P, tachypnea w/shallow depth, tachycardia, SpO2 ≤ 90%, adventitious breath sounds in both lobes, visual secretions, and absence of spontaneous cough. OK. This procedure may cause some temporary coughing, sneezing, gagging, or SOB. This is normal. It is important for you to cough out the secretions and continue to cough throughout the procedure. Do you have any questions about that? Use penlight, look in nose. Keep Pulse Ox on finger. Put towel across chest. Wash hands. Put on face shield. Connect tubing to suction machine. ↑ O2 if indicated or ordered. Encourage deep breathing. Open suction kit or catheter w/aseptic technique. Unwrap/open sterile basin and place on bedside table. Fill w/100 mL sterile normal saline/H20 Open lubricant and squeeze small amount onto open sterile catheter package. Turn on suction device and set regulator to 120 mm Hg
Apply sterile glove to dominant hand. Clean glove to non-dominant hand if have. Connect catheter to tubing. Check if equipment functioning. Lubricate end of catheter (2 – 3 inches) Remove O2 delivery device, if present. Take a deep breath. Insert catheter appropriate distance on inhalation: •
Nasopharyngeal suctioning: 16 cm
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Nasotracheal Suctioning: 14 – 20 cm
Apply intermittent suction for up to 10 seconds. Encourage to continue coughing. Replace O2. Rinse catheter. Wait 1 minute. Apply intermittent suction for up to 10 seconds. Encourage to continue coughing. Replace O2. Rinse catheter. Are you breathing easier now? Great. I am just going to recheck a few things. Is that OK? Reassess lung sounds, SpO2, RR, HR, B/P, and ability to cough up secretions. Document: Naosopharyngeal suctioning completed using sterile technique and 14 Fr catheter. 40 cc’s of thick, yellow secretions obtained. No odor. Client states, “I feel like I can breathe easier.” Secretions are mobilized and airway is maintained free of secretions, as evidenced by clear lung sounds in all areas, SpO2 of 92%, RR 18, BP 120/80, and ability to effectively cough up secretions. Tolerated procedure well without c/o pain or discomfort. NADN. Encouraged client to continue to cough and deep breathe q hour and increase fluid intake.