SUCTIONING NASOPHARYNGEAL AND OROPHARYNGEAL AREAS

1. Determine need for suctioning. Administer pain medication before suctioning to postoperative patient.
2. Explain procedure to patient.
3. Assemble equipment.
4. Perform hand hygiene.
5. Adjust bed to comfortable working position. Lower side rail closet to you. Place patient in a semi-Fowler’s position if he or she is conscious. An unconscious patient should be placed in the lateral position facing you.
6. Place towel or waterproof pad across patient’s chest.
7. Turn suction to appropriate pressure.

1. Wall unit

·        Adult: 100 to 120 cm Hg

·        Child: 95 to 110 cm Hg

·        Infant: 50 to 95 cm Hg

2. Portable unit

·        Adult: 10 to 15 cm Hg

·        Child: 5 to 10 cm Hg

·        Infant: 2 to 5 cm Hg

8. Open sterile suction package. Set up sterile container, touching only the outside surface, and pour sterile saline into it.
9. Don sterile gloves. The dominant hand that will handle catheter must remain sterile, whereas the nondominant hand is considered clean rather than sterile.
10. With sterile gloves. The dominant hand, pick up sterile catheter and connect to suction tubing held with unsterile hand.
11. Moisten catheter by dipping it into container of sterile saline. Occlude Y-tube to check suction.
12. Estimate the distance form earlobe to nostril and place thumb and forefinger of gloved hand at that point on catheter.
13. Using nondominant hand, has the patient take several slow deep breaths. if the patient's oxygen saturation is <94%, or if he is in any distress, administer supplemental oxygen before, during, and after suctioning.
14. Gently insert catheter with suction off by leaving the vent on the Y-connector open. Slip catheter gently along the floor of an unobstructed nostril toward trachea to suction the nasopharynx. Or insert catheter along side of mouth toward trachea to suction the oropharynx. Never apply suction as catheter is introduced.
15. Apply suction by according suctioning port with your thumb. Gently rotate catheter as it is being withdraw. Do not allow suctioning to continue for more than 10 to 15 seconds at a time.
16. Flush the catheter with saline and repeat suctioning as needed and according to patient’s toleration of the procedure.
17. Allow at least a 20- to 30-second interval if additional suctioning is needed. The nares should be alternated when repeated suctioning required. Do not force the catheter through the nares. Encourage patient to cough and breathe deeply between suctioning.
18. When suctioning is completed, remove gloves inside out and dispose of gloves, catheter, and container with solution in proper receptacle. Perform hand hygiene.
19. Use auscultation to listen to chest and breath sounds to assess effectiveness of suctioning.
20. Record time of suctioning and nature and amount of secretions. Also note the character of the patient’s respirations before and after suctioning.
21. Offer oral hygiene after suctioning.

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