| Question | Answer |
| What are a couple airway clearance techniques? | - Suctioning
- Invasive procedure. |
| Suctioning: Airway Clearance Technique | Negative pressure applied within the airway. |
| Invasive procedure: Airway Clearance Technique | - Can be via ET or Trach tube
- Through the nose into trachea. |
| What is it called when you put a tube through the nose into the trachea? | NT or naso- tracheal suctioning |
| What are the indications for suctioning? | - Patient has an inability to clear secretions.
- A sample of sputum is to be obtained for lab analysis purposes. |
| Patient has an inability to clear secretions: | - Ineffective or absent cough (Has need to remove secretions)
- Evidence of retained secretions in upper airway ( coarse crackles/ rhonchi) |
| How do you obtain a sample of sputum for lab analysis purposes when you have to use a suction? | Use a sterile "sputum trap" (Lukens trap) |
| What is an ABSOLUTE contraindication for NT suctioning? | - Evidence of croup
- Epiglottitis |
| What is RELATIVE contraindication for NT suctioning? (Benefits out ways risks) | - Occluded nasal passages
- Nasal bleeding
- Bleeding disorder
- Acute facial, head, or neck injury
- Laryngospasm |
| What are some HAZARDS and COMPLICATIONS of NT Suctioning? | - Hypoxia/ Hypoxemia
- Trauma to nasal passages, pharynx or trachea
- Cardiac or respiratory arrest (vagus nerve stimulation)
- Atelectasis
- Bronchospasm
- Increased ICP (inter cranial pressure) |
| When patients need suctioning? | - Listen over anterior chest with stethoscope and hear evidence of loud rhonchi.
- Does pt have AUDIBLE CRACKLES when breathing with their mouth open.
Does pt have tactile fremitus when you place hand over anterior chest?
- Pt coughs, is it loose but |
| Review chart previous to procedure to confirm? | - The order
- review clinical notes (PO2)
- review medications
- assess for any contraindications |
| What to monitor during suctioning? | - RR & pattern
- ECG tracing, HR
- Skin color; SpO2
- Subjective response
- Sputum
- Evidence of airway bleeding? |
| What are some sputum characteristics? | - color
- consistency
- amount
- oder |
| What equipment is used when suctioning? | - suction regulator
- suction canister to collect secretions
- suction connecting tube
- suction kit |
| What is in a suction kit? | - sterile gloves
- sterile catheter (sheathed or unsheathed)
- basin for irrigation water or sterile water
- lubrication jelly |
| What are some suctioning regulator facts? | - Set on continuous
- read gauge at eye level
- adjust pressure while occluding tubing |
| What are the procedure for suctioning? | - Assess need
- Turn on and set suction pressure on regulator
- Prepare patient
- Make sure patient is oxygenated with 100% - BVM always at bedside or vent at 100% |
| What is the proper pressure for suctioning for children? | negative 80-100 mmHg |
| What is the proper pressure for suctioning an adult? | negative 100-120 mmHg |
| What is the proper pressure for suctioning an infant? | negative 60-80 mmHg |
| The correct order to do a suction procedure? | - Oxygenate patient before procedure.
- open necessary sterile saline or sterile water
- open lubricating jelly
- open kit and put sterile gloves on
- lubricate catheter (NT suction only)
- apply suction ONLY WILE WITHDRAWING using rotating motion. |
| Post suctioning procedure care | - reoxygenate patient after procedure
- monitor pt and assess need for additional suctioning
- Repeat as necessary
- If difficult, leave catheter in with suction off, BVM at 100%, then retry. |
| What type of technique is used when suctioning (NT)? | Aseptic |
| What do you do if sterile (aseptic) technique is broken? | Sart over |
| What position do you want the pt when suctioning (NT)? | semi- fowler if possible |
| Intermittent occlusion vs continuous and use of saline? | - No difference but it causes less trauma
- Regardless removes O2 and volume |
| What size catheter is commonly used for an adult? | 14F |
| What are the other smaller sizes of catheters? | 12F, 10F, 8F, 6F
1F= 1/3 mm.
EX.. -12F = 4mm |
| How to figure out what size catheter to use when suctioning through an ET tube? | - take ET tube size (mmI.D.), multiply by 3, and divide by 2.
- 8.0x3= 24F /2= 12F (Moby's)
or
- take ET tube size (I.D.) and multiply by 2.
- 8.0mm tube x2 = 16F
Next closest size down is 14F (Egan) |
| What is the standard length for a catheter? | 22in long |
| What is the markings on the catheter for neonates for? | Distance markings |
| Whistle tip suction catheter? | has a side opening towards the bottom of the catheter, also has an opening at the tip. |
| Coude tip suction catheter: | bend close to tip, ridged |
| What is the most common closed- system multi- use ET suction catheter system? | Ballard (now generic) |
| What is a closed- system muti- use ET catheter also called? | oxygen insufflation catheter |
| True or False:
You need to disconnect from ventilator when suctioning a patient? | False |
| How long can a closed- system multi- use ET catheter be used? | for extended periods (1-3 days) |
| True or False:
Closed- system multi- use ET catheters are cost effective? | True |
