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Suctioning
- 1. Suctioning BY Dr. Sachin chaudhary. M.P.Th ( Cardiovascular & Respiratory PT) DMCOP Nagpur.
- 2. LEARNING OBJECTIVES Sr. no Learning objectives domain level criteria 1 Indication of suctioning. Cognitive Must know All 2 Explain types of suctioning. Cognitive & Psychomotor Must know All 3 Explain types of suctioning equipments. Cognitive & Psychomotor Must know All 4 Explain precaution & hazards of suctioning. Cognitive & Psychomotor Must know All
- 3. OBJECTIVES • INDICATIONS • TYPES • EQUIPMENTS • PROCEDURE • PRECAUTIONS • HAZARDS
- 4. INDICATIONS • Whenever the secretions are heard in an intubated patient • Retained secretions in patient who is unable to cough • Unconscious, weak or neurologically impaired Patient • Before & during the release of the cuff of tracheostomy tube.
- 5. Types • Nasopharyngeal • Oropharyngeal • Endotracheal
- 7. Equipments • Portable Suction apparatus • Suction catheters • Suction trolley: Sterile lubricating gel Normal saline Sterile plastic gloves Sterile gauze swabs Sodium bicarbonate • Manual resuscitation bag
- 8. Endotracheal suctioning • Check equipments & make sure that all necessary equipments are reachable • Check monitor. • Wash your hands • Inform patient about the procedure • Hyperoxygnate with 100% O2 for 3 to 5 breaths with manual resuscitation bag • Place the patients neck in extension • Lubricate catheter with sterile saline • Kink the catheter and then insert it till the resistance is felt (Carina) • Pull the catheter slightly out & release the kink •Negative suction pressure for Adults: -100 to -120 mmHg •Negative suction pressure for children : - 80 to -100 mmHg •Negative suction pressure for Neonates : - 50 to -80 mmHg •Do no extend the suction time for more than 15 seconds. •The patient is allowed to rest for several seconds & again the procedure is repeated. •Check the breath sounds & repeat the procedure if necessary. •Always check for monitors for O2 saturation & arrythmias. •Discard the used equipments & wash hands.
- 9. Nasopharyngeal suction • Extend the patient’s neck & the head is tilted backwards resting on a pillow • Ask the patient to protrude the tongue if he/she cooperates. • Lubricate the catheter & insert it backwards & upwards untill the resistance is felt. • Gentle rolling of the catheter at this point allows the advancement of the catheter into pharynx. • The catheter should be inserted during inspiration with mouth open. The aim is to stimulate cough reflex. • It must be remembered that it is a very unpleasant experience hence should only be used when absolutely necessary.
- 10. • Always observe the patient for signs of Hypoxia • If patient already has low PaO2, oxygenate the patient or hyperinflate if patient is intubated • If the patient is mechanically ventilated, never disconnect the patient for more than 15 seconds. • If possible, rotate the head to one side while suctioning to avoid the aspiration of gastric contents. • Reconnect the patient immediately to ventilator or oxygen supply after suctioning. • Check for deviated nasal septum, nasal polyps or nasal fractures before nasal suctioning PRECAUTIONS
- 11. Hazards of suctioning • Risk of infection if its not performed under sterile conditions • Trauma due to incorrect choice of catheter & excessive negative pressure • Hypoxia • Cardiac arrhythmias • Atelectasis
- 12. Question • Indications of suctioning. • Types of suctioning apparatus. • Types of catheter used in suctioning. • Types of suctioning. • Hazards of suctioning.
- 13. Bibliography • Cash textbook of medical & surgical .
- 14. Thank you