The purpose of oral suctioning is to maintain a patent airway and improve oxygenation by removing mucous secretions and foreign material vomit or gastric secretions from the mouth and throat oropharynx. Published guidelines provide little information related to use of. Because microaspiration of secretions is a risk factor for vap, assessment of practices related to oral suctioning, oral care, and management of endotracheal tube is important. The general principles of suctioning are the same, whether the child requires suction of the mouth, pharynx or via. Retained secretion is causing patient distress or physiological derangement e. Closed suctioning is defined as suctioning through a tightfitting device on the endotracheal tube that allows the ventilator to be connected and working during suctioning. The procedure involves patient preparation, the suctioning events and. Endotracheal suctioning special consideration amount of negative pressure for suctioning portable suction unit wall suction unit adult 815 mm of hg 100120mmhg children 58 mm of hg 50100mm of hg infant 35 mm of hg 4060mm of hg 15. The two methods of et tube suctioning are the opensuctioning method and the closedsuctioning method. Table 1 indications, contraindications and hazards of suctioning indications of suctioning 1.
Suctioning definition of suctioning by medical dictionary. Suctioning the airway is an essential part of routine care of the tracheostomy and laryngectomy patient. Ventilate the patient from ambu bag lubricate the catheter with sterile water or normal saline turn on suction unit with clean hand contd. Pdf knowledge about endotracheal suctioning on the part. Table 1 indications, contraindications and hazards of suctioning. Tracheostomy care and suctioning saskatoon health region. Control of the airway with endotracheal tube is usually regarded as the gold standard c. An electronic literature search for articles published between january 1990 and october 2009 was conducted by using medline, cinahl, and cochrane library databases. Turn off continuous milk feed prior to procedure to assist in the prevention of aspiration of milk. Oral suction is the use of a rigid plastic suction catheter, known as a yankauer see figure 5. Open suction involves using singleuse catheters inserted via the open end of the tracheostomy tube. If the patient has secretions or emesis that cannot be removed quickly and easily by suctioning, the patient should be log rolled and the oropharynx should be cleared take body substance isolation precautions. Suctioning artificial airways saskatoon health region. Closed suction systems allow the same catheter to be used multiple times.
Closed suctioning appears to be an effective and costefficient method of endotracheal suctioning that is associated with fewer suctioninduced complications. The procedures for endotracheal within the trachea suctioning are similar to those used for naso and oropharyngeal suctioning with two major differences. Open suctioning is defined as suctioning the airway after the endotracheal tube has been disconnected from the ventilator. Used the least amount of negative pressure necessary to remove secretions. Suctioning of the nose and mouth is a relatively simple procedure. The purpose is to clear secretions from the airway, to maintain a patent airway and to optimize ventilation and oxygenation.
Sandy and kathleen demonstrating endotracheal suctioning. Definition removal of the secretion from the oral cavity or nasal cavity and pharynx through the suction. Catheter is inserted until resistance is met and then withdrawn approximately 1 cm before applying suctioning shallow suctioning. Pdf the gap between knowledge and practice in standard endo. Open suctioning requires disconnecting the neonate from the ventilator. Suctioning an adult icu patient with an artificial airway agency for.
Normal saline instillation with suctioning of endotracheal. A high suction pressure and a lengthy suctioning time will greatly decrease the amount of oxygen in the alveoli. Endotracheal suctioning is a vital process to keep the airways. The potential for haemodynamic, respiratory and neurological compromise is significant with this procedure, which needs.
They are especially useful if the patient is connected to a breathing circuit of a. Open suctioning involves a sterile, singleuse catheter and sterile gloves. Patient has an ineffective cough and unable to clear the secretion spontaneously audible secretion sound in patients under mechanical ventilation 2. Endotracheal suctioning is the insertion of a catheter and the removal of secretions from an artificial airway, using a suction device attached to a negative pressure vacuum setup. Suctioning uk national tracheostomy safety project. Wear the sterile gloves and use the dominant hand for suction connect suction catheter from suction unit with other hand clean hand. Endotracheal suctioning of mechanically ventilated.
A clinical practice guideline, 2014 suctioning a tracheal tube is a frequent and integral activity of airway management in an adult intensive care unit. The catheter is attached to suction tubing that connects to a suction regulator. From principles to practice article pdf available in intensive care medicine 306. The main goal of oxygen therapy is to prevent hypoxemia, thereby preventing hypoxia that could result in tissue damage and cell death. Suctioning is the mechanical aspiration of pulmonary secretions from a patient with an.
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