Respiratory Care Science 2: Suctioning

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Questions and Answers

What is the primary purpose of using a nasopharyngeal airway?

  • To prevent airway obstruction
  • To administer medication directly
  • To facilitate repeated suctioning (correct)
  • To enhance oxygen delivery

Who is authorized to insert a nasopharyngeal airway?

  • Any healthcare professional on duty
  • Only those with specific training (correct)
  • Emergency responders without training
  • Family members of the patient

What should be anticipated when planning to use a nasopharyngeal airway?

  • Reduced oxygen saturation
  • Repeated suctioning procedures (correct)
  • Minimal need for suctioning
  • Increased risk of airway obstruction

Which of the following is NOT a characteristic of a nasopharyngeal airway?

<p>Can be inserted by untrained individuals (A)</p> Signup and view all the answers

What is essential to consider before using a nasopharyngeal airway?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary purpose of suctioning in a clinical setting?

<p>To remove obstruction from the airway (A)</p> Signup and view all the answers

Which of the following is a key difference between oropharyngeal/nasopharyngeal suctioning and endotracheal/tracheostomy suctioning?

<p>Endotracheal suctioning is done through an artificial airway. (D)</p> Signup and view all the answers

What is the primary purpose of suctioning in patients with an artificial airway?

<p>To remove pulmonary secretions (C)</p> Signup and view all the answers

Which of the following sites can suctioning be performed?

<p>Oral and nasal passages, along with trachea (C)</p> Signup and view all the answers

Which of the following sites is NOT commonly used for suctioning?

<p>Mediastinal (D)</p> Signup and view all the answers

What is the sequence of events in the suctioning procedure?

<p>Patient preparation, suctioning, follow-up care (A)</p> Signup and view all the answers

What are common indications for performing suctioning?

<p>Presence of oral secretions or inability to clear airway (B)</p> Signup and view all the answers

Which term best describes the act of removing fluid or secretions from the airway?

<p>Suctioning (C)</p> Signup and view all the answers

Which suction tube is specifically mentioned for its rigidity?

<p>Rigid Yankauer Suction Tube (C)</p> Signup and view all the answers

Which type of airway is generally associated with the need for tracheostomy suctioning?

<p>Artificial airway (B)</p> Signup and view all the answers

What factors should be recorded in the procedure regarding mucus assessment?

<p>Consistency, color, odor, and breathing status (D)</p> Signup and view all the answers

Why is it important to assess breathing status before and after mucus examination?

<p>To evaluate lung function changes (C)</p> Signup and view all the answers

Which element is NOT part of the mucus assessment procedure?

<p>Sound of breathing (B)</p> Signup and view all the answers

What does evaluating the color of mucus indicate?

<p>Presence of infection or inflammation (B)</p> Signup and view all the answers

What should be compared in the evaluation of mucus?

<p>Both mucus characteristics and breathing status before and after assessment (A)</p> Signup and view all the answers

What method is mentioned for estimating the NPA length?

<p>Measuring from the tip of the nose to the tragus of the ear (C)</p> Signup and view all the answers

What is stated about the validation of the NPA length estimation method in adults?

<p>It has not been validated in adults (A)</p> Signup and view all the answers

Which part of the anatomy is NOT involved in estimating the NPA length according to the provided method?

<p>Chin (C)</p> Signup and view all the answers

Which other method could be misleading if used for estimating NPA length?

<p>Using an age-based scale (A)</p> Signup and view all the answers

Why might the estimation of NPA length from the nose to the tragus be significant in clinical practice?

<p>It provides a quick assessment for catheter selection (A), It prevents complications from incorrect sizing (B)</p> Signup and view all the answers

Which of the following parameters is NOT typically monitored during the procedure?

<p>Nutritional intake (D)</p> Signup and view all the answers

What is the purpose of using sterile normal saline in the equipment assembly for the procedure?

<p>Maintaining catheter patency (D)</p> Signup and view all the answers

Which of the following is NOT a hemodynamic parameter to be monitored?

<p>Respiratory rate (A)</p> Signup and view all the answers

In the assembly of equipment for the procedure, which item is specifically used for pre and post oxygenation?

<p>AMBU bag (C)</p> Signup and view all the answers

Which of the following parameters would provide information about the patient's respiratory effort?

<p>Cough effort (D)</p> Signup and view all the answers

Flashcards

Suctioning

A procedure used to remove secretions from the airway using a suction catheter connected to a suction device.

Sites for Suctioning

The areas where suctioning is performed depending on the location of the secretions.

Difference Between Types of Suctioning

Oropharyngeal and nasopharyngeal suctioning involve removing secretions from the mouth and nose, respectively. Endotracheal and tracheostomy suctioning, on the other hand, involve removing secretions from the trachea through an endotracheal tube or a tracheostomy.

Purposes of Suctioning

To maintain a clear airway and improve oxygenation and ventilation by removing secretions.

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Indications for Suctioning

Signs and symptoms that indicate the need for suctioning, such as coughing, wheezing, difficulty breathing, increased respiratory rate, and decreased oxygen saturation.

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Nasopharyngeal airway

A type of airway inserted through the nose into the pharynx to maintain an open airway.

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Suction

A procedure using suction to clear the airway of mucus or other obstructions.

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Repeated suction

Repeated suction suggests a situation where there's frequent need to clear the airway.

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When to use a nasopharyngeal airway

Using a nasopharyngeal airway is recommended when repeated suction is needed to maintain an open airway.

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Who can insert a nasopharyngeal airway?

Only trained individuals should insert a nasopharyngeal airway.

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What is suctioning?

Removing accumulated mucus or secretions from the airway using suction equipment.

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What is oropharyngeal suctioning?

Suctioning involving the mouth and nose for removing secretions.

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What is nasopharyngeal suctioning?

Suctioning involving the nose for removing secretions.

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What is endotracheal suctioning?

Suctioning through a tube inserted in the windpipe (trachea).

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What is tracheostomy suctioning?

Suctioning through an opening in the neck directly connected to the windpipe (trachea).

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NPA Length Estimation in Adults

Measuring the distance from the tip of the nose to the tragus of the ear to estimate the length of a nasopharyngeal airway (NPA) is NOT a reliable method for adults.

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Nasopharyngeal Airway (NPA)

A device inserted through the nose into the pharynx to maintain an open airway.

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Recurring Suctioning

Repeated suctioning might indicate a frequent need to clear the airway, suggesting an underlying issue.

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Respiratory monitoring

Monitoring a patient's respiratory status, including breath sounds, oxygen saturation, respiratory rate and pattern, and coughing effort, is crucial to assess overall airway health and identify potential issues.

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Hemodynamic monitoring

Monitoring vital signs like pulse rate and blood pressure provides valuable insights into a patient's cardiovascular health and how their body is responding to the procedure.

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Sputum analysis

Analyzing characteristics of sputum (color, volume, consistency, and odor) can help diagnose underlying respiratory conditions and guide medical treatment.

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Sterile suction catheter

The suction catheter is a sterile tool used to remove secretions from the airway, ensuring a clear passage for breathing.

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AMBU bag oxygenation

The AMBU bag, a manual breathing device, delivers supplemental oxygen to a patient before and after procedures to maintain adequate oxygen levels.

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Mucus Characteristics

The color, consistency, and odor of the mucus being removed from the airway.

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Breathing Status

The client's breathing before and after suctioning, noting any improvement or worsening.

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Nasopharyngeal Suctioning

Suctioning performed through the nose to remove secretions.

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Oropharyngeal Suctioning

Suctioning performed through the mouth to remove secretions.

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Study Notes

Respiratory Care Science 2: Suctioning

  • Course instructor: DR:MOHAMMED-SENAN
  • Course Year: 2nd
  • Course dates: 21-Dec-24 - 24-Dec-24
  • Topic: Suctioning
  • Airway Clearance (Suctioning) is a procedure that removes airway secretions or foreign material using negative pressure.
  • Yankauer Suction Catheter: A rigid suction device used for oropharyngeal suction.
  • Oropharyngeal Suction (OP): Requires an airway adjunct (e.g., Guedel airway). Should not be done regularly but is useful for intubated/ventilated patients.
  • Nasopharyngeal Suction (NP): Can be done directly through the nostril without an airway adjunct. A nasopharyngeal airway may be used for repeated suctioning, but insertion is only by trained personnel. Suction involves mechanically removing pulmonary secretions from a patient with an airway. The procedure includes patient preparation, suctioning, and follow-up care.
  • Sites for Suctioning: Oropharyngeal, Nasopharyngeal, Tracheostomy, and Endotracheal.
  • Rigid Yankauer Suction Tube: A pictured example of a rigid suction device.
  • Differences Between Oropharyngeal/Nasopharyngeal and Endotracheal/Tracheostomy Suctioning: Oropharyngeal/Nasopharyngeal suctioning removes secretions from the upper respiratory tract, while endotracheal/tracheostomy suctioning removes secretions from the lower respiratory tract (trachea and bronchi).
  • Purposes of Suctioning: Oral/Nasal suctioning is used to maintain oral/nasal hygiene, comfort, and emergency removal of blood or vomit. Tracheal/Endotracheal suctioning maintains a patent airway by removing tracheobroncheal secretions, prevents lower respiratory tract infection, provides effective ventilation, and stimulates coughing.

Terminology

  • Airway Suction: Removal of airway secretions by artificial means.

  • Yankauer Suction Catheter: A rigid suction tip used to aspirate secretions from the oropharynx.

  • Oropharyngeal Suction: Requires an airway adjunct and is used to remove secretions from the oropharynx.

  • Nasopharyngeal Suction: Can be via the nostril without an airway adjunct for removing secretions from the nasopharynx.

Definition

  • Nasopharyngeal Suction: direct suction through the nostril without an airway adjunct. Should be done by trained personnel.
  • Suction: Mechanical aspiration of pulmonary secretions from a patient with an airway.

Sites for Suctioning

  • Oropharyngeal, Nasopharyngeal, Tracheostomy, Endotracheal

Choosing the Right Size Catheter

  • Adults: #12 to #18
  • Children: #8 to #10
  • Infants: #5 to #8
  • Catheter size is critical. Correct size tracks from the patient's mouth to the jaw angle. Incorrect size can cause tongue obstruction.
  • Estimating NPA length: distance from the nose tip to the tragus of the ear (validated in children, not fully in adults)

Setting the Correct Pressure

  • Pressure varies by age and equipment:
  • Adult (Wall unit): 100 to 120 mm Hg
    • Adult (Portable): 10 to 15 mm Hg
  • Child (Wall unit): 95 to 110 mm Hg
    • Child (Portable): 5 to 10 mm Hg
  • Infant (Wall unit): 50 to 95 mm Hg
    • Infant (Portable): 2 to 5 mm Hg

Types of ET Suctioning

  • Closed Suction: Minimizes contamination by staying disconnected from the ventilator.
  • Open Suction: Catheter is placed in the endotracheal tube, after removing the patient from the ventilator.

Patient Preparation

  • Explain the procedure to a conscious patient
  • Hyperoxygenate with 100% oxygen for 30 seconds before suctioning.
  • Position the patient supine.
  • Auscultate breath sounds before, during, and after

Assessment

  • Monitor breath sounds, oxygen saturation, respiratory rate and pattern, hemodynamic parameters (pulse rate, blood pressure).
  • Cough effort.
  • ICP (if appropriate)
  • Sputum characteristics (color, volume, consistency, odor)
  • Ventilator parameters (PIP, Vt, FiO2)

Equipment Assembly

  • Stethoscope
  • Vacuum source with adjustable regulator/suction jar
  • Sterile gloves
  • Sterile suction catheter
  • Protective goggles/apron/mask
  • Sterile normal saline
  • AMBU bag for pre/post oxygenation

Documentation

  • Record the amount, consistency, color, and odor of mucus.
  • Note client breathing status before and after procedure.

Complications

  • Hypoxia
  • Tracheal or bronchial mucosal trauma
  • Cardiac or respiratory arrest
  • Pulmonary hemorrhage/bleeding
  • Cardiac dysrhythmias
  • Pulmonary atelectasis
  • Bronchospasm
  • Hypotension/hypertension
  • Elevated ICP

References

  • Provided in slide 28. Lists relevant books.

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