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Suctioning
Airway Suctioning
Term | Definition |
---|---|
Suctioning Purpose | Patent Airway, Specimen Collection, Stimulate Cough |
Suctioning Indications | Accumulated Secretions, Obstructed Airway, Depressed Cough, Inability to swallow |
Suctioning Hazards of Suctioning | Trauma to Mucosa (most common) lubricate catheter( nasal- tracheal-suctioning) use gentle technique |
Suctioning Hazards of Suctioning | Contamination use aseptic technique |
Suctioning Hazards of Suctioning | Hypoxemia-leading to tachycardia, arrhythmia (most severe) |
Suctioning Hazards of Suctioning | Bradycardia from vagus nerve stimulation |
Suctioning Hazards of Suctioning | suctioning to vigorous may cause bleeding |
Suctioning Procedure | 100% O2pre and post suction. oxygenate for 1-2 minutes Close cardiac monitoring to detect iatrogenic hypoxemia. Sterile catheter, solutions and gloves each time. Suction ET tube then mouth, change after suction mouth then ET tube |
Suctioning Equipment: Vacuum regulators | Used to adjust vacuum pressure |
Suctioning Equipment: Vacuum regulators Adults | 100-120mmHg |
Suctioning Equipment: Vacuum regulators Child | 80-100mmHg |
Suctioning Equipment: Vacuum regulators Infants | 60-80mmHg |
Suctioning Equipment: Vacuum regulators | Adjust with tubing occluded A built in shut off device in the collection bottle prevents aspirated secretions from entering the regulator and vacuum system when the bottle is full |
Suctioning Equipment: Suction Catheter Specimen Collection | Each designed to reduce trauma to mucosa must have a bevel tip with 2 opening to decrease tracheal damage and a thumb port |
Suctioning Equipment: Suction Catheter Coude Tip | Suction LEFT mainstem |
Suctioning Equipment: Suction Catheter Ballard | allow the patient to receive ventilation and oxygenation during suctioning. |
Suctioning Equipment: Suction Catheter Ballard | indicated for patients with high PEEP and oxygen requirements, pulmonary infection, frequent suctioning, hemodynamic instability. Plastic sleeve to prevent contamination |
Suctioning Equipment: Sizes | ideal catheter length 20-22 in French Units(Circumference) External no greater than ET tube internal diameter |
Suctioning Equipment: Suction Catheter size Formula | ID SIZE/2 x 3 |
Suctioning Equipment: Suction Catheter Yankauer/Tonsil | used to suction mouth nose, throat aseptic technique |
Suctioning Equipment: Lukens Trap Sterile Suction Trap | used to collect sputum specimen placed in an upright position between suction catheter and suction tube. flush catheter with sterile water or isotonic saline |
Modify Suction Difficultly Remove Secretions | having difficult removing secretions verify appropriate cath size for patient ET Tube |
Modify Suction Left Mainstem Bronchus | Change To Coude Tip |
Modify Suction Pt. Special Needs to | Closed system Pt. has an infection, High PEEP levels, or desaturation during suctioning. |
Modify Suction Alter Negative Pressure | INCREASE: To remove Thick Tenacious Secretions DO NOT EXCEED recommended vacuum pressure |
Modify Suction Instill irrigating solutions: Normal Saline | 5-10mL Normal Saline- to dilute secretions too thick to aspirate through suction catheter |
Modify Suction Instill irrigating solutions: Acetylcsteine | 5-10mL of 10% Solution of Acetylcsteine (Mucomyst) can be used for thick secretions |
Modify Suction Alter Frequency | Suctioning is Hazardous and should be done (PRN)ONLY |
Modify Suction Duration/Cardiac Arrhythmias | Catheter should be in the airway no longer than 15secs If cardiac arrhythmias occur: STOP suction and decrease the amount of time in the airway |
Modify Suction Adverse Reactions | Suctioning should be STOPPED if hazards occur. The level of vacuum should be reduced and further suctioning should be gone gently and in less time. |
Modify Suction Troubleshooting | check catheter for patency, assure vacuum system working properly, change or empty a full collection bottle, check all connections |