Description #
Description: This unit is designed to review the techniques of oral, nasal and tracheal suctioning with an emphasis on clinical relevance to physiotherapists and physiotherapy students. This unit will be administered online followed by a pre and post quiz. Accumulated knowledge from all of the units will be practiced and evaluated via case scenarios using the simulated patient.
Learning Objectives #
At the completion of this module the student will be able to:
Identify suctioning materials.
Understand the differences between oral, nasal and tracheal suctioning techniques.
Understand the difference between clean and sterile suctioning techniques.
Understand necessary clinical reasoning skills of when to suction patients.
Practical Application #
Insertion of Airways #
The following section will outline the procedure of inserting an airway (NPA/OPA) and how to perform the technique of suctioning.
An airway should be considered if it is likely that the patient will require regular suctioning, as the airway will serve to protect the mucosa from damage that occurs with repeated suctioning.
Problem Solving #
Tips for successful suctioning #
If possible, tip the patients head back. This will help to align the Pharynx with the Trachea.
If your patient is compliant, you can ask them to poke out their tongue, which further helps with alignment.
Alternatively a jaw thrust will be sufficient to facilitate alignment.
If your patient is using their voice, the chances of slipping the suction catheter past the vocal cords is low.
Lubricant will help the catheter to slide inside the airway, and especially in patients with dry mucosa.
Ensure that the airway (Especially NPA) is the correct size. A large NPA in a small person could result in the catheter being directed into the Oesophagus.
Try to time insertion of the catheter with the patients inhalation, as the airways dilate during inhalation therefore making a larger target.
Consider patient fatigue when treating the patient.
If the patient is agitated/Delirius, you may need assistance from another person
Do not forget to use other adjunctive therapies (Percs/Vibs/Assisted Coughs) when suctioning a patients, as these can often increase the effectiveness of the treatment.
Use of an airway is not compulsory, however it will generally make the suction procedure more comfortable for the patient.
Video: Lower Airway Anatomy #
Video: Nasal Airway Sizing #
Video: Nasal Airway Insertion #
Video: Oral Airway Sizing #
Video: Oral Airway Insertion #
References #
1. Brooks, D., Anderson, C., Carter, M., et al. (2001).Clinical practice guidelines for suctioning the airway of the intubated and nonintubated patient.Canadian Respiratory Journal, 8(3), 163:181.
2. Burton, G., Hodgkin, J., & Ward, J. (1997). Respiratory Care A Guide to Clinical Practice.Philadelphia:Lippincott.
3. Finucane, B., & Santora, A. (1996).Airway Management Second Edition.St. Louis:Mosby.
4. Fiorentini A: Potential hazards tracheobronchial suctioning. Int Crit Care Nurs 1992; 8:217.
5. Frownfelter, D., & Dean, E. (2006).Cardiovascular and Pulmonary Physical Therapy Evidence and Practice Fourth Edition.St. Louis:Mosby.
6. Niel-Weise, B., Snoeren, R., Van Den Boek, P. (2007). Policies for Endotracheal Suctioning of Patients Receiving Mechanical Ventilation: A Systematic Review of Randomized Controlled Trials. Infection Control and Hospital Epidemiology, 28(5)531:536.
7. Thompson, L. (2000). Suctioning adults with an artificial airway: a systematic review. Joanna Briggs Institute for Evidence Based Nursing and Midwifery, 1:95.