Suctioning is an activity performed by the nurse to aspirate excess oral and pulmonary secretions through a catheter passed into the mouth or nasal cavity of a child. The catheter may be connected to a tubing which is fixed to the suction machine or wall suction outlets. A bulb syringe or penguin can also be used.
Aims
· Maintain a patent airway to improve ventilation and oxygenation
· Prevent chest infection caused by secretions accumulated in tubes (Tracheostomy tube)
· Obtain airway secretions for microbiological analysis
· Prevent pulmonary aspiration which may lead to lung infection
Types
· Oropharyngeal
· Nasopharyngeal
· Endotracheal (artificial airways)
· Orotracheal
· Nasotracheal
· Tracheostomy tubes
Requirements
a. Cotton wool swabs
b. Suction machine
c. Goggles
d. Suction connecting tubing
e. Suction catheter (appropriate size)
f. Stethoscope
g. Gallipot with water
h. Normal Saline
i. Receiver
j. Paper tissue
k. Self-inflating bag
l. Water soluble Lubricant
m. Protective mackintosh/Bed mat
n. Sterile gloves
o. Examination gloves
p. Water proof trash bag
q. Face mask
r. Rubber apron
Steps
1. Establish rapport (refer steps)
2. Explain procedure to child or caregiver/family (refer steps)
3. Allow caregiver to take a decision of either staying or leaving the resuscitation area
4. Provide privacy
5. Observe the following before suctioning: Respiratory rate, pulse, skin colour, breath sounds with stethoscope
6. Perform hand hygiene and don examination gloves
7. Disinfect and set a tray for the procedure
8. Ensure the proper functioning of the suction apparatus
9. Set appropriate suctioning pressure that is, Neonates; 60–80mmHg child; 80–100mmHg;
10. Place child in the prop-up position or high Fowler’s position as condition demands
11. Perform hand hygiene
12. Put on goggles, face mask, rubber apron and sterile gloves
13. Open suction catheter and connect to the tube of the suction machine
14. Insert catheter gently from side to side into the mouth and into the throat where necessary to aspirate secretions (taking note of the type of suctioning)
15. Insert catheter gently upwards and backwards into the nostrils
16. Move the catheter around gently to aspirate secretions
17. Suction intermittently with a maximum duration of 5-10sec.
18. Observe child for signs of respiratory distress throughout the procedure and ventilate with bag and mask if necessary
19. Withdraw catheter gently, applying continuous suctioning pressure by placing the thumb over the suction control port (depending on the type of catheter)
20. Observe the secretions for colour, consistency, odour and amount
21. Clean child’s mouth (if condition permits) with clean water and wipe the lips with tissue paper
22. Put patient desirable position
23. Clean the catheter of debris by flushing with sterile water
24. Dispose off, decontaminate and clean used items
25. Remove gloves and perform hand hygiene
26. Evaluate effectiveness of the suctioning by conducting a comprehensive post suctioning respiratory assessment
27. Document procedure in the nurse’s notes
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