SKILL: Oropharyngeal and Nasopharyngeal Suctioning
PREPARATION
1. Assess for clinical signs indicating the need for suctioning
Restlessness
Gurgling sounds during respiration
Skin color
Rate and pattern of respiration
Pulse rate and rhythm
Decreased oxygen saturation
2. Assemble equipment: to save time and be organized
For oral and nasopharyngeal:
Towel
Suction machine
Sterile disposable container
Sterile saline
Sterile gloves
Suction catheter
Lubricant
PROCEDURE
1. Introduce yourself and verify the client’s identity and explain procedure.
To reduce client’s anxiety and to encourage cooperation of the client
2. Perform hand hygiene. To avoid the spread of microorganism and avoid cross contamination
3. Provide for client privacy by closing the door or window to preserved client’s integrity
4. Prepare the client.
For conscious patient:
Supine (nakahiga)
For unconscious patient:
Lateral (nakaside)
5. Prepare the equipment.
Open lubricant
Moisten catheter tip
6. Open sterile suction package
Set up the cup touching only the outside
Pour sterile saline
Put on sterile gloves
Pick up the catheter and attach to suction unit.
7. Lubricate and introduce the catheter
Lubricate the catheter tip
8. Perform suctioning
Apply your finger to the suction control port to start suction and gently rotate the catheter
Apply suction for 5-10 seconds while slowly withdrawing the catheter, then remove your finger from the
control and remove the catheter.
(suction attempt should last only 10-15 seconds, catheter is inserted, applied, and discontinued and
removed)
9. Rinse the catheter, and repeat suctioning.
Rinse and flush the catheter with sterile saline
Relubricate the catheter and repeat suctioning
Allow sufficient time between each suction, limit suctioning to 5 minutes in total.
Encourage deep breathing and coughing
10. Promote client comfort
Oral/Nasal hygiene
Assist client into a position that facilities breathing
11. Dispose of equipment and ensure availability for the next suction
12. Assess the effectiveness of suctioning
Auscultate client’s breath sounds
Observe skin color, dyspnea, oxygen saturation, level of anxiety
13. Document relevant data to prove that the procedure is done to the client and to serve as a data.
Record:
Amount
Consistency
Color
Odor