SlideShare a Scribd company logo
1 of 5
Download to read offline
EMS SKILL
AIRWAY EMERGENCY / AIRWAY MANAGEMENT
SUCTIONING - OROPHARYNGEAL
PERFORMANCE OBJECTIVES
Demonstrate competency in performing oropharyngeal suctioning using a rigid and flexible suction catheter and a bulb syringe.
CONDITION
Suction a simulated patient who is either conscious or unresponsive and is unable to maintain a patent airway due to copious oral secretions.
Necessary equipment will be adjacent to the patient or brought to the field setting.
EQUIPMENT
Simulated adult and pediatric airway management manikin, oxygen tank with connecting tubing, suction device with connecting tubing, or
hand-powered suction device with adaptor, hard and flexible suction catheters, bulb syringe, normal saline irrigation solution, container,
gloves, goggles, masks, gown, waste receptacle, timing device.
PERFORMANCE CRITERIA
Items designated by a diamond ( ) must be performed successfully to demonstrate skill competency.
Items identified by double asterisks (**) indicate actions that are required if indicated.
Items identified by (§) are not skill component items, but should be practiced.
A clean technique must be maintained throughout suctioning procedure.
PREPARATION
Skill Component Key Concepts
Take body substance isolation precautions Mandatory personal protective equipment - gloves, goggles
Situational - masks, gown
Assess patient for the need to suction oral secretions Indications for suctioning: noisy respirations, coughing up
secretions, respiratory distress or patient request.
Open suction kit or individual supplies Use the inside of the wrapper to establish a clean field.
Fill container with irrigation solution Saline or water is used to flush suction catheter as needed.
Ensure suction device is working
** Set appropriate suction setting:
Adult - between 80-120 mmHg
Pediatric and the elderly - between 50-100mmHg
Battery operated suction machine or hand-powered suction devices
may be used. An adaptor for a flexible catheter is required with
hand-powered suction devices.
Excessive negative pressures may cause significant hypoxia,
damage to tracheal mucosa or lung collapse.
Measure depth of catheter insertion from corner of mouth
to edge of ear lobe
Never insert catheter past the base of the tongue. This may
stimulate the gag reflex and cause vomiting.
RIGID CATHETER (TONSIL TIP, YANKAUER)
PROCEDURE
Skill Component Key Concepts
Remove oxygen source - if indicated Oxygen should be maintained until ready to suction.
A nasal cannula does not need to be removed for oropharyngeal
suctioning.
Connect rigid catheter to suction tubing/device Keep catheter in package until ready to use.
Provide a clean field for catheter if reuse is indicated.
Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010
Page 1 of 5
Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010
Page 2 of 5
Skill Component Key Concepts
Open patient’s mouth by applying pressure on the chin
with your thumb
Thumb pressure on the chin displaces the jaw. DO NOT use fingers
to open the mouth. The Acrossed-finger@ technique may result in
injury to the rescuer and may puncture gloves.
Note: The crossed-finger method is a step found on the National
Registry Skills Exam.
DO NOT force teeth open. Use a flexible catheter if unable to open
the mouth.
Insert rigid catheter into mouth without applying suction The patient is not being oxygenated during this step and applying
suction would deplete any oxygen reserve.
Advance catheter gently to depth measured Never insert catheter past the base of the tongue. This may
stimulate the gag reflex, cause vomiting and bradycardia.
Suction while withdrawing using a circular motion around
mouth, pharynx and gum line
** Maximum suction time of 5-15 seconds:
Adults maximum 10-15 seconds
Peds maximum of 5-10 seconds
Suctioning longer than recommended time will result in hypoxia.
Maximum suction time depends on patient’s age and tolerance.
Rigid catheters are contraindicated for infants less than 1 year of
age.
Replace oxygen source or ventilate patient at
approximate rate of:
Adult - 10-20/minute
Peds - 12-20/minute
Ventilation rates for pediatric patients vary due to a wide age range.
Evaluate airway patency and heart rate - repeat
procedure if needed
Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety,
bronchospasms and changes in mental status.
If vagal stimulation occurs, the patient may experience bradycardia,
especially pediatric patients.
Allow patient to rest and regain adequate oxygen levels between
suction attempts.
Suction remaining water into canister, discard container
and change gloves
Irrigation solution is contaminated and should be treated the same
as secretions.
Discard or secure contaminated catheter in a clean area:
Discard into an approved receptacle
OR
Return used catheter to package and place in clean
area for future use
Provide a clean field for catheter if reuse is indicated.
FLEXIBLE CATHETER (WHISTLE STOP, FRENCH)
PROCEDURE
Skill Component Key Concepts
Remove oxygen source - if indicated Oxygen should be maintained until ready to suction.
A nasal cannula does not need to be removed for oropharyngeal
suctioning.
Connect flexible catheter to suction tubing/device Keep catheter in package until ready to use.
Provide a clean field for catheter if reuse is indicated.
Open patient’s mouth by applying pressure on the chin with
your thumb
Thumb pressure on the chin displaces the jaw. DO NOT use fingers
to open the mouth. The Acrossed-finger@ technique may result in
injury to the rescuer and may puncture gloves.
Note: The crossed-finger method is a step found on the National
Registry Skills Exam.
DO NOT force teeth open. Use a flexible catheter if unable to open
the mouth.
Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010
Page 3 of 5
Skill Component Key Concepts
Insert flexible catheter along the roof of the mouth without
applying suction
The patient is not being oxygenated at this time and applying suction
would deplete any oxygen reserve that is present.
Advance catheter gently to depth measured Never insert catheter past the base for the tongue. This may
stimulate the gag reflex, cause vomiting and bradycardia.
Suction while withdrawing moving catheter from side to
side around mouth, pharynx and gum line
** Maximum suction time of 5-15 seconds:
Adults maximum 10-15 seconds
Children maximum of 5-10 seconds
Infants - no longer than 5 seconds
Suctioning longer than recommended time will result in hypoxia.
Maximum suction time depends on patient’s age and tolerance:
Replace oxygen source or ventilate patient at
approximate rate of:
Adult - 10-12/minute
Child - 12-20/minute
Infant - 20-30/minute
Neonate - 30-60/minute
The range for pediatric patients varies due to a wide age range.
Evaluate airway patency and heart rate - repeat
procedure if needed
Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety,
bronchospasms and changes in mental status.
If vagal stimulation occurs, the patient may experience bradycardia,
especially pediatric patients.
Allow patient to rest and regain adequate oxygen levels between
suction attempts.
Discard or secure in a clean area contaminated catheter:
Discard into an approved receptacle:
- Coil contaminated catheter around sterile (dominant)
hand and pull glove over catheter
- Pull glove from other hand over packaged catheter
and discard in approved waste receptacle
OR
Return used catheter to package and place in clean area
for future use
Suction remaining water into canister, discard container
and change gloves
Rinse solution is contaminated and should be treated the same as
secretions.
BULB SYRINGE
PROCEDURE
Skill Component Key Concepts
Prime bulb (squeeze out air) and hold in depressed
position
The bulb syringe acts as both the Apump@ and collection container for
manual suction.
To prime bulb syringe depress (squeeze) it to remove all air and
hold.
Open patient’s mouth by applying pressure on the chin with
your thumb
Thumb pressure on the chin displaces the jaw. DO NOT use fingers
to open the mouth. The Acrossed-finger@ technique may result in
injury to the rescuer and may puncture gloves.
Note: The crossed-finger method is a step found on the National
Registry Skills Exam.
Insert tip of primed syringe into mouth and advance gently
to back of mouth
DO NOT insert tip past the base of the tongue. This may stimulate
the gag reflex, cause vomiting and bradycardia.
Slowly release pressure on bulb to draw secretions into
syringe
The bulb syringe acts as both the Apump@ and collection container for
manual suction.
Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010
Page 4 of 5
Skill Component Key Concepts
Remove syringe from mouth
Empty secretions into designated container by squeezing
bulb several times
All secretions are to be treated as contaminated waste.
Replace oxygen source or ventilate patient at
approximate rate of:
Adult - 10-12/minute
Child - 12-20/minute
Infant - 20-30/minute
Neonate - 30-60/minute
The rate for ventilating pediatric patients varies due to a large age
range.
Evaluate airway patency and heart rate - repeat
procedure if needed
Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety,
bronchospasms and changes in mental status.
If vagal stimulation occurs, the patient may experience bradycardia,
especially pediatric patients.
Allow patient to rest and regain adequate oxygen levels between
suction attempts.
Rinse bulb syringe with irrigation solution Rinsing bulb syringe removes secretions for future use.
Return used bulb syringe to package/container and place in
clean area for future use
Discard irrigation solution into designated container and
change gloves
Irrigation solution is contaminated and should be treated the same
as secretions.
REASSESSMENT
(Ongoing Assessment
Skill Component Key Concepts nts
§ Assess airway, breathing and heart rate:
Continuously or at least every 5 minutes
Changes in airway sounds
Changes in respiratory status
If vagal stimulation occurs, the patient may experience bradycardia,
especially pediatric patients.
Evaluate response to treatment
• Patients must be re-evaluated at least every 5 minutes if any
treatment was initiated or medication administered.
PATIENT REPORT AND DOCUMENTATION
Skill Component Key Concepts
§ Verbalize/Document
Indication for suctioning
Oxygen liter flow
Patient’s tolerance of procedure
Problems encountered
Type of secretions:
- color
- consistency
- quantity
- odor
Respiratory assessment and heart rate:
- respiratory rate
- effort/quality
- tidal volume
- lung sounds
Documentation must be on either the Los Angeles County EMS
Report form or departmental Patient Care Record form.
Developed: 12/02 Revised: 1/05, 1/10
AIRWAY EMERGENCY / AIRWAY MANAGEMENT
SUCTIONING - OROPHARYNGEAL
Supplemental Information
INDICATIONS: To clear the airway in patients who are unable to maintain a patent airway due to oral secretions.
• Excessive oral secretions (noisy respirations)
• Respiratory distress due to oral secretions/vomitus
• Prevent aspiration of secretions/vomitus
COMPLICATIONS:
• Hypoxia
• Bronchospasm
• Cardiac dysrhythmias
• Hypotension
• Oral trauma/broken teeth
• Infection/sepsis
• Vomiting
• Aspiration
CONTRAINDICATION:
• Infants less than 1 year of age – use bulb syringe
NOTES:
• A clean technique must be maintained throughout suctioning procedure to prevent infection.
• Use rigid catheters with caution in conscious or semiconscious patients. Put the tip of the catheter in only as far as can be visualized to
prevent activating the gag reflex.
• Rigid catheters are best for suctioning large amount of secretions or large particles.
• Keep suction settings between 80-120 mmHg and adjust lower for pediatric and elderly patients (50-100mmHg). Excessive negative
pressures may cause significant hypoxia and damage to tracheal mucosa. Too little suction will be ineffective.
• Hand-powered suction devices may be used as long as they have an adaptor for a flexible catheter.
• Pre-oxygenation may be required depending on patient=s condition. This offsets volume and oxygen loss during suctioning.
• Suctioning longer than recommended time will result in hypoxia. Maximum suction time depends on patient=s age and tolerance:
- Adults maximum 10-15 seconds
- Children maximum of 5-10 seconds
- Infants - no longer than 5 seconds
• If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients.
Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010
Page 5 of 5

More Related Content

What's hot (20)

Clearence of the tracheobroncial secreations
Clearence of the tracheobroncial secreationsClearence of the tracheobroncial secreations
Clearence of the tracheobroncial secreations
 
NGT handouts
NGT handoutsNGT handouts
NGT handouts
 
Ng tube insertion & feeding, CAREOFNG TUBE SHIVA NAGU
Ng tube insertion & feeding, CAREOFNG TUBE SHIVA NAGUNg tube insertion & feeding, CAREOFNG TUBE SHIVA NAGU
Ng tube insertion & feeding, CAREOFNG TUBE SHIVA NAGU
 
Steam inhalation
Steam inhalationSteam inhalation
Steam inhalation
 
Manual respiratory bypass
Manual respiratory bypassManual respiratory bypass
Manual respiratory bypass
 
Nasogastric Tube Insertion
Nasogastric Tube InsertionNasogastric Tube Insertion
Nasogastric Tube Insertion
 
Suctioning Procedure
Suctioning  ProcedureSuctioning  Procedure
Suctioning Procedure
 
Nasogastric intubation
Nasogastric  intubation Nasogastric  intubation
Nasogastric intubation
 
Rt insertion
Rt insertionRt insertion
Rt insertion
 
Nasogastric Tube (NGT) insertion and removal
Nasogastric Tube (NGT) insertion and removalNasogastric Tube (NGT) insertion and removal
Nasogastric Tube (NGT) insertion and removal
 
instillation and irrigation of eye,ear.nose
instillation and irrigation of eye,ear.noseinstillation and irrigation of eye,ear.nose
instillation and irrigation of eye,ear.nose
 
Mechanical ventilation intro
Mechanical ventilation   introMechanical ventilation   intro
Mechanical ventilation intro
 
Insertion of NG tube
Insertion of NG tubeInsertion of NG tube
Insertion of NG tube
 
Suction
SuctionSuction
Suction
 
Airway management
Airway managementAirway management
Airway management
 
What You Need to Know About Your Child's Tracheostomy
What You Need to Know About Your Child's TracheostomyWhat You Need to Know About Your Child's Tracheostomy
What You Need to Know About Your Child's Tracheostomy
 
Ng tube feeding
Ng tube feedingNg tube feeding
Ng tube feeding
 
Ryles tube insertion
Ryles tube insertionRyles tube insertion
Ryles tube insertion
 
Inhalations
InhalationsInhalations
Inhalations
 
Nasogastric intubation
Nasogastric intubationNasogastric intubation
Nasogastric intubation
 

Viewers also liked

Getting a grip on Creative Commons: what CC licences are and how to use them ...
Getting a grip on Creative Commons: what CC licences are and how to use them ...Getting a grip on Creative Commons: what CC licences are and how to use them ...
Getting a grip on Creative Commons: what CC licences are and how to use them ...ccAustralia
 
El origen de la agricultura
El origen de la agriculturaEl origen de la agricultura
El origen de la agriculturaedelmira777
 
Six Brand Leadership Strategies Enabling a Flourishing Future
Six Brand Leadership Strategies Enabling a Flourishing FutureSix Brand Leadership Strategies Enabling a Flourishing Future
Six Brand Leadership Strategies Enabling a Flourishing FutureSustainable Brands
 
The Tangent Ratio
The Tangent RatioThe Tangent Ratio
The Tangent RatioPassy World
 
Arquitectura de sistemas distribuidos-grupo Maria
Arquitectura de sistemas distribuidos-grupo MariaArquitectura de sistemas distribuidos-grupo Maria
Arquitectura de sistemas distribuidos-grupo Mariagequito
 
Mujeres en el Islam
Mujeres en el IslamMujeres en el Islam
Mujeres en el Islamrochipoggi
 
Propiedades físicas y químicas del alcohol
Propiedades físicas y químicas del alcoholPropiedades físicas y químicas del alcohol
Propiedades físicas y químicas del alcoholCristian_B
 
SQL Server 2008 新增的 T-SQL 與資料型態
SQL Server 2008 新增的 T-SQL 與資料型態SQL Server 2008 新增的 T-SQL 與資料型態
SQL Server 2008 新增的 T-SQL 與資料型態Chui-Wen Chiu
 
Criterios De OperaciòN
Criterios De OperaciòNCriterios De OperaciòN
Criterios De OperaciòNCarlos Arturo
 
C++ Windows Forms L04 - Controls P3
C++ Windows Forms L04 - Controls P3C++ Windows Forms L04 - Controls P3
C++ Windows Forms L04 - Controls P3Mohammad Shaker
 
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...Mauricio Portugal Ribeiro
 
About Ag 1 Source
About Ag 1 SourceAbout Ag 1 Source
About Ag 1 SourceAg 1 Source
 
Content 101: How to Create Content People Actually Care About
Content 101: How to Create Content People Actually Care About Content 101: How to Create Content People Actually Care About
Content 101: How to Create Content People Actually Care About Intelligent_ly
 
040408horariobachillerato
040408horariobachillerato040408horariobachillerato
040408horariobachilleratoCarmen
 
OSM & K-12 Education SotM US 2012 PDX
OSM & K-12 Education SotM US 2012 PDXOSM & K-12 Education SotM US 2012 PDX
OSM & K-12 Education SotM US 2012 PDXgwhathistory
 
FacultyClub_7en8Juni2010
FacultyClub_7en8Juni2010FacultyClub_7en8Juni2010
FacultyClub_7en8Juni2010mr38schev
 

Viewers also liked (20)

Modulo iii proeja medio
Modulo iii proeja medioModulo iii proeja medio
Modulo iii proeja medio
 
Getting a grip on Creative Commons: what CC licences are and how to use them ...
Getting a grip on Creative Commons: what CC licences are and how to use them ...Getting a grip on Creative Commons: what CC licences are and how to use them ...
Getting a grip on Creative Commons: what CC licences are and how to use them ...
 
El origen de la agricultura
El origen de la agriculturaEl origen de la agricultura
El origen de la agricultura
 
Six Brand Leadership Strategies Enabling a Flourishing Future
Six Brand Leadership Strategies Enabling a Flourishing FutureSix Brand Leadership Strategies Enabling a Flourishing Future
Six Brand Leadership Strategies Enabling a Flourishing Future
 
Propiedades físicas de los alcoholes
Propiedades físicas de los alcoholesPropiedades físicas de los alcoholes
Propiedades físicas de los alcoholes
 
The Tangent Ratio
The Tangent RatioThe Tangent Ratio
The Tangent Ratio
 
Arquitectura de sistemas distribuidos-grupo Maria
Arquitectura de sistemas distribuidos-grupo MariaArquitectura de sistemas distribuidos-grupo Maria
Arquitectura de sistemas distribuidos-grupo Maria
 
Mujeres en el Islam
Mujeres en el IslamMujeres en el Islam
Mujeres en el Islam
 
Propiedades físicas y químicas del alcohol
Propiedades físicas y químicas del alcoholPropiedades físicas y químicas del alcohol
Propiedades físicas y químicas del alcohol
 
SQL Server 2008 新增的 T-SQL 與資料型態
SQL Server 2008 新增的 T-SQL 與資料型態SQL Server 2008 新增的 T-SQL 與資料型態
SQL Server 2008 新增的 T-SQL 與資料型態
 
Criterios De OperaciòN
Criterios De OperaciòNCriterios De OperaciòN
Criterios De OperaciòN
 
C++ Windows Forms L04 - Controls P3
C++ Windows Forms L04 - Controls P3C++ Windows Forms L04 - Controls P3
C++ Windows Forms L04 - Controls P3
 
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...
ERROS E ACERTOS NO USO DO PLANO DE NEGÓCIOS E DA METODOLOGIA DO FLUXO DE CAIX...
 
About Ag 1 Source
About Ag 1 SourceAbout Ag 1 Source
About Ag 1 Source
 
Content 101: How to Create Content People Actually Care About
Content 101: How to Create Content People Actually Care About Content 101: How to Create Content People Actually Care About
Content 101: How to Create Content People Actually Care About
 
Presentation1
Presentation1Presentation1
Presentation1
 
040408horariobachillerato
040408horariobachillerato040408horariobachillerato
040408horariobachillerato
 
OSM & K-12 Education SotM US 2012 PDX
OSM & K-12 Education SotM US 2012 PDXOSM & K-12 Education SotM US 2012 PDX
OSM & K-12 Education SotM US 2012 PDX
 
FacultyClub_7en8Juni2010
FacultyClub_7en8Juni2010FacultyClub_7en8Juni2010
FacultyClub_7en8Juni2010
 
Ten trends 2011
Ten trends 2011Ten trends 2011
Ten trends 2011
 

Similar to EMS SKILL: AIRWAY SUCTIONING

10 airway management-npa
10 airway management-npa10 airway management-npa
10 airway management-npasojhk
 
airwaysuctioning-150627145142-lva1-app6892.pdf
airwaysuctioning-150627145142-lva1-app6892.pdfairwaysuctioning-150627145142-lva1-app6892.pdf
airwaysuctioning-150627145142-lva1-app6892.pdfSubi Babu
 
10 airway management-opa
10 airway management-opa10 airway management-opa
10 airway management-opasojhk
 
airway-management 1.docx
airway-management 1.docxairway-management 1.docx
airway-management 1.docxsithuswe009
 
Airway Management
Airway Management Airway Management
Airway Management paramedicbob
 
suctioning-procedure-ppt full.pptx
suctioning-procedure-ppt full.pptxsuctioning-procedure-ppt full.pptx
suctioning-procedure-ppt full.pptxAkshataBansode1
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxthakurarjunrawat99
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxthakurarjunrawat99
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxthakurarjunrawat99
 
suctioning-211013092839.pptx
suctioning-211013092839.pptxsuctioning-211013092839.pptx
suctioning-211013092839.pptxSubi Babu
 
218935884-16744678-Safe-Suctioning.ppt
218935884-16744678-Safe-Suctioning.ppt218935884-16744678-Safe-Suctioning.ppt
218935884-16744678-Safe-Suctioning.pptHemant620457
 
Air way suctioning for nurses in emergency room
Air way suctioning for nurses in emergency roomAir way suctioning for nurses in emergency room
Air way suctioning for nurses in emergency roomMelakuSintayhu
 
Cincinnati children s hospital tracheostomy book
Cincinnati   children s hospital tracheostomy bookCincinnati   children s hospital tracheostomy book
Cincinnati children s hospital tracheostomy bookAndrés Dante Podestá
 
Nasogastric Insertion maintenancel lavage.pptx
Nasogastric Insertion maintenancel lavage.pptxNasogastric Insertion maintenancel lavage.pptx
Nasogastric Insertion maintenancel lavage.pptxmichelle505237
 
Endotracheal intubation
Endotracheal intubationEndotracheal intubation
Endotracheal intubationAdnanQadir13
 
Airwaymanagement 101212112449-phpapp01
Airwaymanagement 101212112449-phpapp01Airwaymanagement 101212112449-phpapp01
Airwaymanagement 101212112449-phpapp01Abdullhakeem Hussein
 

Similar to EMS SKILL: AIRWAY SUCTIONING (20)

10 airway management-npa
10 airway management-npa10 airway management-npa
10 airway management-npa
 
airwaysuctioning-150627145142-lva1-app6892.pdf
airwaysuctioning-150627145142-lva1-app6892.pdfairwaysuctioning-150627145142-lva1-app6892.pdf
airwaysuctioning-150627145142-lva1-app6892.pdf
 
10 airway management-opa
10 airway management-opa10 airway management-opa
10 airway management-opa
 
airway-management 1.docx
airway-management 1.docxairway-management 1.docx
airway-management 1.docx
 
Suctioning
Suctioning Suctioning
Suctioning
 
Airway Management
Airway Management Airway Management
Airway Management
 
Pediatric airway management
Pediatric airway managementPediatric airway management
Pediatric airway management
 
suctioning-procedure-ppt full.pptx
suctioning-procedure-ppt full.pptxsuctioning-procedure-ppt full.pptx
suctioning-procedure-ppt full.pptx
 
intubation.pptx
intubation.pptxintubation.pptx
intubation.pptx
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptx
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptx
 
SUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptxSUCTIONING ARITIFICIAL AIRWAYS.pptx
SUCTIONING ARITIFICIAL AIRWAYS.pptx
 
suctioning-211013092839.pptx
suctioning-211013092839.pptxsuctioning-211013092839.pptx
suctioning-211013092839.pptx
 
Suctioning
SuctioningSuctioning
Suctioning
 
218935884-16744678-Safe-Suctioning.ppt
218935884-16744678-Safe-Suctioning.ppt218935884-16744678-Safe-Suctioning.ppt
218935884-16744678-Safe-Suctioning.ppt
 
Air way suctioning for nurses in emergency room
Air way suctioning for nurses in emergency roomAir way suctioning for nurses in emergency room
Air way suctioning for nurses in emergency room
 
Cincinnati children s hospital tracheostomy book
Cincinnati   children s hospital tracheostomy bookCincinnati   children s hospital tracheostomy book
Cincinnati children s hospital tracheostomy book
 
Nasogastric Insertion maintenancel lavage.pptx
Nasogastric Insertion maintenancel lavage.pptxNasogastric Insertion maintenancel lavage.pptx
Nasogastric Insertion maintenancel lavage.pptx
 
Endotracheal intubation
Endotracheal intubationEndotracheal intubation
Endotracheal intubation
 
Airwaymanagement 101212112449-phpapp01
Airwaymanagement 101212112449-phpapp01Airwaymanagement 101212112449-phpapp01
Airwaymanagement 101212112449-phpapp01
 

Recently uploaded

Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableNehru place Escorts
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️  8250192130 Independent Escort Service CoimbatoreCall Girl Coimbatore Prisha☎️  8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatorenarwatsonia7
 
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaCall Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaPooja Gupta
 
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls ServiceCall Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Servicenarwatsonia7
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Miss joya
 
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment BookingHousewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Bookingnarwatsonia7
 
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...narwatsonia7
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Deliverynehamumbai
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...Nehru place Escorts
 

Recently uploaded (20)

Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
 
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
 
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
 
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️  8250192130 Independent Escort Service CoimbatoreCall Girl Coimbatore Prisha☎️  8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
 
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Yelahanka Just Call 7001305949 Top Class Call Girl Service Available
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service NoidaCall Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
 
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls ServiceCall Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
Call Girls Service Bellary Road Just Call 7001305949 Enjoy College Girls Service
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
 
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment BookingHousewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
 
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...
Russian Call Girls in Chennai Pallavi 9907093804 Independent Call Girls Servi...
 

EMS SKILL: AIRWAY SUCTIONING

  • 1. EMS SKILL AIRWAY EMERGENCY / AIRWAY MANAGEMENT SUCTIONING - OROPHARYNGEAL PERFORMANCE OBJECTIVES Demonstrate competency in performing oropharyngeal suctioning using a rigid and flexible suction catheter and a bulb syringe. CONDITION Suction a simulated patient who is either conscious or unresponsive and is unable to maintain a patent airway due to copious oral secretions. Necessary equipment will be adjacent to the patient or brought to the field setting. EQUIPMENT Simulated adult and pediatric airway management manikin, oxygen tank with connecting tubing, suction device with connecting tubing, or hand-powered suction device with adaptor, hard and flexible suction catheters, bulb syringe, normal saline irrigation solution, container, gloves, goggles, masks, gown, waste receptacle, timing device. PERFORMANCE CRITERIA Items designated by a diamond ( ) must be performed successfully to demonstrate skill competency. Items identified by double asterisks (**) indicate actions that are required if indicated. Items identified by (§) are not skill component items, but should be practiced. A clean technique must be maintained throughout suctioning procedure. PREPARATION Skill Component Key Concepts Take body substance isolation precautions Mandatory personal protective equipment - gloves, goggles Situational - masks, gown Assess patient for the need to suction oral secretions Indications for suctioning: noisy respirations, coughing up secretions, respiratory distress or patient request. Open suction kit or individual supplies Use the inside of the wrapper to establish a clean field. Fill container with irrigation solution Saline or water is used to flush suction catheter as needed. Ensure suction device is working ** Set appropriate suction setting: Adult - between 80-120 mmHg Pediatric and the elderly - between 50-100mmHg Battery operated suction machine or hand-powered suction devices may be used. An adaptor for a flexible catheter is required with hand-powered suction devices. Excessive negative pressures may cause significant hypoxia, damage to tracheal mucosa or lung collapse. Measure depth of catheter insertion from corner of mouth to edge of ear lobe Never insert catheter past the base of the tongue. This may stimulate the gag reflex and cause vomiting. RIGID CATHETER (TONSIL TIP, YANKAUER) PROCEDURE Skill Component Key Concepts Remove oxygen source - if indicated Oxygen should be maintained until ready to suction. A nasal cannula does not need to be removed for oropharyngeal suctioning. Connect rigid catheter to suction tubing/device Keep catheter in package until ready to use. Provide a clean field for catheter if reuse is indicated. Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010 Page 1 of 5
  • 2. Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010 Page 2 of 5 Skill Component Key Concepts Open patient’s mouth by applying pressure on the chin with your thumb Thumb pressure on the chin displaces the jaw. DO NOT use fingers to open the mouth. The Acrossed-finger@ technique may result in injury to the rescuer and may puncture gloves. Note: The crossed-finger method is a step found on the National Registry Skills Exam. DO NOT force teeth open. Use a flexible catheter if unable to open the mouth. Insert rigid catheter into mouth without applying suction The patient is not being oxygenated during this step and applying suction would deplete any oxygen reserve. Advance catheter gently to depth measured Never insert catheter past the base of the tongue. This may stimulate the gag reflex, cause vomiting and bradycardia. Suction while withdrawing using a circular motion around mouth, pharynx and gum line ** Maximum suction time of 5-15 seconds: Adults maximum 10-15 seconds Peds maximum of 5-10 seconds Suctioning longer than recommended time will result in hypoxia. Maximum suction time depends on patient’s age and tolerance. Rigid catheters are contraindicated for infants less than 1 year of age. Replace oxygen source or ventilate patient at approximate rate of: Adult - 10-20/minute Peds - 12-20/minute Ventilation rates for pediatric patients vary due to a wide age range. Evaluate airway patency and heart rate - repeat procedure if needed Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety, bronchospasms and changes in mental status. If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients. Allow patient to rest and regain adequate oxygen levels between suction attempts. Suction remaining water into canister, discard container and change gloves Irrigation solution is contaminated and should be treated the same as secretions. Discard or secure contaminated catheter in a clean area: Discard into an approved receptacle OR Return used catheter to package and place in clean area for future use Provide a clean field for catheter if reuse is indicated. FLEXIBLE CATHETER (WHISTLE STOP, FRENCH) PROCEDURE Skill Component Key Concepts Remove oxygen source - if indicated Oxygen should be maintained until ready to suction. A nasal cannula does not need to be removed for oropharyngeal suctioning. Connect flexible catheter to suction tubing/device Keep catheter in package until ready to use. Provide a clean field for catheter if reuse is indicated. Open patient’s mouth by applying pressure on the chin with your thumb Thumb pressure on the chin displaces the jaw. DO NOT use fingers to open the mouth. The Acrossed-finger@ technique may result in injury to the rescuer and may puncture gloves. Note: The crossed-finger method is a step found on the National Registry Skills Exam. DO NOT force teeth open. Use a flexible catheter if unable to open the mouth.
  • 3. Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010 Page 3 of 5 Skill Component Key Concepts Insert flexible catheter along the roof of the mouth without applying suction The patient is not being oxygenated at this time and applying suction would deplete any oxygen reserve that is present. Advance catheter gently to depth measured Never insert catheter past the base for the tongue. This may stimulate the gag reflex, cause vomiting and bradycardia. Suction while withdrawing moving catheter from side to side around mouth, pharynx and gum line ** Maximum suction time of 5-15 seconds: Adults maximum 10-15 seconds Children maximum of 5-10 seconds Infants - no longer than 5 seconds Suctioning longer than recommended time will result in hypoxia. Maximum suction time depends on patient’s age and tolerance: Replace oxygen source or ventilate patient at approximate rate of: Adult - 10-12/minute Child - 12-20/minute Infant - 20-30/minute Neonate - 30-60/minute The range for pediatric patients varies due to a wide age range. Evaluate airway patency and heart rate - repeat procedure if needed Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety, bronchospasms and changes in mental status. If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients. Allow patient to rest and regain adequate oxygen levels between suction attempts. Discard or secure in a clean area contaminated catheter: Discard into an approved receptacle: - Coil contaminated catheter around sterile (dominant) hand and pull glove over catheter - Pull glove from other hand over packaged catheter and discard in approved waste receptacle OR Return used catheter to package and place in clean area for future use Suction remaining water into canister, discard container and change gloves Rinse solution is contaminated and should be treated the same as secretions. BULB SYRINGE PROCEDURE Skill Component Key Concepts Prime bulb (squeeze out air) and hold in depressed position The bulb syringe acts as both the Apump@ and collection container for manual suction. To prime bulb syringe depress (squeeze) it to remove all air and hold. Open patient’s mouth by applying pressure on the chin with your thumb Thumb pressure on the chin displaces the jaw. DO NOT use fingers to open the mouth. The Acrossed-finger@ technique may result in injury to the rescuer and may puncture gloves. Note: The crossed-finger method is a step found on the National Registry Skills Exam. Insert tip of primed syringe into mouth and advance gently to back of mouth DO NOT insert tip past the base of the tongue. This may stimulate the gag reflex, cause vomiting and bradycardia. Slowly release pressure on bulb to draw secretions into syringe The bulb syringe acts as both the Apump@ and collection container for manual suction.
  • 4. Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010 Page 4 of 5 Skill Component Key Concepts Remove syringe from mouth Empty secretions into designated container by squeezing bulb several times All secretions are to be treated as contaminated waste. Replace oxygen source or ventilate patient at approximate rate of: Adult - 10-12/minute Child - 12-20/minute Infant - 20-30/minute Neonate - 30-60/minute The rate for ventilating pediatric patients varies due to a large age range. Evaluate airway patency and heart rate - repeat procedure if needed Observe patient for hypoxemia: dysrhythmias, cyanosis, anxiety, bronchospasms and changes in mental status. If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients. Allow patient to rest and regain adequate oxygen levels between suction attempts. Rinse bulb syringe with irrigation solution Rinsing bulb syringe removes secretions for future use. Return used bulb syringe to package/container and place in clean area for future use Discard irrigation solution into designated container and change gloves Irrigation solution is contaminated and should be treated the same as secretions. REASSESSMENT (Ongoing Assessment Skill Component Key Concepts nts § Assess airway, breathing and heart rate: Continuously or at least every 5 minutes Changes in airway sounds Changes in respiratory status If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients. Evaluate response to treatment • Patients must be re-evaluated at least every 5 minutes if any treatment was initiated or medication administered. PATIENT REPORT AND DOCUMENTATION Skill Component Key Concepts § Verbalize/Document Indication for suctioning Oxygen liter flow Patient’s tolerance of procedure Problems encountered Type of secretions: - color - consistency - quantity - odor Respiratory assessment and heart rate: - respiratory rate - effort/quality - tidal volume - lung sounds Documentation must be on either the Los Angeles County EMS Report form or departmental Patient Care Record form. Developed: 12/02 Revised: 1/05, 1/10
  • 5. AIRWAY EMERGENCY / AIRWAY MANAGEMENT SUCTIONING - OROPHARYNGEAL Supplemental Information INDICATIONS: To clear the airway in patients who are unable to maintain a patent airway due to oral secretions. • Excessive oral secretions (noisy respirations) • Respiratory distress due to oral secretions/vomitus • Prevent aspiration of secretions/vomitus COMPLICATIONS: • Hypoxia • Bronchospasm • Cardiac dysrhythmias • Hypotension • Oral trauma/broken teeth • Infection/sepsis • Vomiting • Aspiration CONTRAINDICATION: • Infants less than 1 year of age – use bulb syringe NOTES: • A clean technique must be maintained throughout suctioning procedure to prevent infection. • Use rigid catheters with caution in conscious or semiconscious patients. Put the tip of the catheter in only as far as can be visualized to prevent activating the gag reflex. • Rigid catheters are best for suctioning large amount of secretions or large particles. • Keep suction settings between 80-120 mmHg and adjust lower for pediatric and elderly patients (50-100mmHg). Excessive negative pressures may cause significant hypoxia and damage to tracheal mucosa. Too little suction will be ineffective. • Hand-powered suction devices may be used as long as they have an adaptor for a flexible catheter. • Pre-oxygenation may be required depending on patient=s condition. This offsets volume and oxygen loss during suctioning. • Suctioning longer than recommended time will result in hypoxia. Maximum suction time depends on patient=s age and tolerance: - Adults maximum 10-15 seconds - Children maximum of 5-10 seconds - Infants - no longer than 5 seconds • If vagal stimulation occurs, the patient may experience bradycardia, especially pediatric patients. Airway Emergency – Suctioning – Oropharyngeal © 2002, 2005, 2010 Page 5 of 5