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wwallace suction
wwallace RT2 suctioning
| Question | Answer |
|---|---|
| Whistle tip catheter | tip is cut at an angle and has one or more eyes or ports cut in the side. |
| What is the advantage of an eye or port in a catheter | keeps vacuum from biopsying mucosal during suctioning |
| Coude tip | has a bend or angle at the distal end, allows for directional entry into right or left mainstem bronchi |
| Argyle aeroflow catheter | donut shaped tip with multiple port holes |
| Closed suction system | catheter in sealed plastic for protection, distal end is attached to modified aerosol T proximal to control valve, replace ea 24 hrs, used on vent |
| Besides convenience, why is a closed suction system used | primary is to keep pt VT, FIO2 and PEEP up, secondary is convenient, cheap, less contamination, good for 24 hrs |
| What is a rigid tonsillar aka yankauers | hard plastic catheter specifically for oropharynx suctioning |
| Oropharyngeal airway | curved shaped device that separates the tongue from the posterior wall of the pharynx to relieve obstructions in unconscious pt |
| How is a oropharyngeal airway inserted | with tip up, rotate 180 degrees as it goes in |
| Why and how is correct sizing important in oropharyngeal airway | to small and soft tissue may still obstruct, to large may push epiglottis against larynx closing airway, correct is at base of tongue, measure from middle ear to tip of nose |
| Why is oropharyngeal airway not tolerated by conscious pt | gag reflex may be strongly stimulated, may result in vomiting and aspiration |
| What is a nasopharyngeal airway | soft rubber tube placed in one of the nares, used in a conscious and semiconscious pt when tongue or soft tissue is causing obstruction |
| What is a nasal trumpet | nasopharyngeal airway |
| What size nasal trumpet is best | largest diameter that can easily pass with minimal force or trauma, length should be from the ear tragus (middle pointy on cheek) to the end of the nose. |
| If the nasal trumpet is not sized correctly what problems may occur | to small may not correct airway obstruction, proper fit should rest at base of tongue, to large may cause larynex to block airway |
| What is a suction regulator | reduces the high negative pressure to a manageable and safe physiological level, single stage, 0-200 mmhg (neg) |
| What is the suction pressure for adults | -100 to -120 |
| What is the suction pressure for Peds | -80 to -100 |
| What is the suction pressure for neonates | -60 to -80 |
| Indication for suction are | primary is to remove secretions, maintain a patent airway in the presence of evidence of secretions audible and physical ie: crackles, rhonchi, diminished BS, obstruction, CSR with opacity, tachycardia, tactile fremitis, spo2 |
| Contraindications of suctioning are | occlude nasal passages, nasal bleeding, Epiglottitis or croup, acute head face or neck injury, bleeding disorder, laryngospasm, irritable airway, upper resp tract infection |
| What is a Lukens trap | specimen trap that can be placed in a vacuum circuit to collect sputum |
| What is the only suction catheter that can go down the left bronchi | coude tip |
| What is the biggest hazard of suctioning | hypoxia or hypoxemia |
| Hazards of suctioning are | mechanical trauma-pharynx perf, laceration of nasal turbinate, bleeding, tracheitis, hypoxemia, cardiac dysrhythmia bradycardia, hyper or hypotention, resp arrest, uncontrolled cough, gag, vomit, laryngospasm, bronchospasm, pain, infection, atelectasis |
| How can suctioning cause atelectasis | catheter to big or suction press to high |
| Assessment of need for suctioning | auscultation, effectiveness of cough |
| Why can suctioning cause bradycardia | touching the corina with the catheter can stimulate the vagal nerve |
| Assessment of outcome | improved breath sounds, removed secretions |
| Pt monitoring during suctioning should include | BS, skin color, breathing pattern and rte, pulse, rhythm, sputum, bleeding or evidence of trauma, pt subjective response, cough, spo2, ICP if available |
| Manual resuscitator flow should be set at what prior to suctioning | 10 to 15 |
| Suction kit includes | sterile catheter, gloves and basin |
| Equipment preparation for suctioning includes | manual resuscitator, suction kit, goggles or face mask, sterile normal saline, sterile distilled water, vacuum regulator, suction trap if needed, ky jelly |
| Sterile distilled water needs replaced how often | every 72 hours, be sure to date when opening |
| What is position of pt for suctioning | semi fowler sniffing or supine if unable to semi fowler |
| How do we prevent hypoxemia in suctioning | preoxygenate pt at 100 percent O2 for 1 to 2 minutes |
| Why do we hyperinflate pt prior to suctioning | helps to avoid hypoxemia and vagal stimulation in vented pts |
| How far does RTT insert catheter | 8 to 10 inches or until pt coughs |
| How long do we suction a pt for | application of vacuum should be no longer than 15 seconds |
| Artificial airway aspiration | direct passage below the larynx |
| How much saline is instilled in artificial airway if secretions are thick | 3 cc |
| How often do we oxygenate pts when suctioning artificial airways | between each pass |
| How do you estimate the size of a suction catheter | 2 x ET tube size and then down one size , so ET tube of 6 is 12 so catheter is 10 french |
| RTT ready to suction pt but no suction, what might be problem | leak at suction trap or vacuum line, canister may be full, suction not turned on |
| pt has PVC's during suction, what should RTT do | stop, give 100 % O2, once stable continue suction |
| how does RTT reduce trauma to mucosa during suctioning | rotate catheter, do not exede reconmended pressure, use largest cath possible with out going over 1/2 |
Created by:
williamwallace
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