syllabus question

Study Notes

Oropharyngeal Suctioning

Purpose: remove secretions, blood, or other debris from the mouth and pharynx
Technique: use a rigid tonsillar (Yankauer) suction tip

Airway Suctioning

Purpose: remove secretions from the lungs and airways
Hazards:
Alveolar hypoxia
Airway collapse
Mucosal trauma
Sympathetic and parasympathetic stimulation
Clinical indications:
Visible secretions
Abnormal breath sounds
Increased ventilator pressure
Abnormal ventilator waveform pattern
Techniques:
Deep suctioning: suction catheter inserted beyond the carina
Shallow suctioning: suction catheter inserted only into the trachea
Infection control in open catheter suction technique:
Use sterile gloves and equipment
Use a sterile suction catheter
Steps in performing open catheter airway suction:
Patient identification and professional approach
Selecting the correct catheter size (outside diameter)
Assembling and testing the equipment
Selecting the correct suction pressure
Duration of the suction procedure
Inline (closed) suction catheters:
Advantages: reduced risk of contamination, reduced risk of infection
Disadvantages: increased risk of occlusion, increased cost

Nasotracheal Suctioning

Indications:
Nasal trauma
Pharyngeal reflex stimulation and vomiting
Procedure: use a nasal suction catheter to remove secretions from the trachea

Obtaining Airway Secretion (Sputum) Samples

Infection control and aseptic technique:
Use sterile gloves and equipment
Use a sterile suction catheter
Handling and transport of the sample:
Use a sterile container
Label the container with patient information and date
Transport to the laboratory immediately

Pharyngeal Airways

Oropharyngeal airways are used for patients who require brief periods of airway support and are conscious or semi-conscious
Contraindications for oropharyngeal airways include severe gag reflex, active bleeding, and risk of aspiration
Oropharyngeal airway selection is based on patient's size, age, and airway anatomy
Oropharyngeal airway sizing is determined by measuring from the corner of the mouth to the earlobe or angle of the jaw
Oropharyngeal airway insertion involves rotating the airway 90 degrees during insertion and checking for correct placement by feeling for resistance and listening for air leaks
Assessing correct oropharyngeal airway placement involves checking for symmetric chest rise and bilateral breath sounds
Nasopharyngeal airways are used for patients who require prolonged periods of airway support and are conscious or semi-conscious
Contraindications for nasopharyngeal airways include severe nasal trauma, bleeding, or deformity
Nasopharyngeal airway selection is based on patient's size, age, and nasal anatomy
Nasopharyngeal airway sizing is determined by measuring from the nostril to the earlobe or angle of the jaw
Nasopharyngeal airway insertion involves lubricating the airway and rotating it during insertion
Assessing correct nasopharyngeal airway placement involves checking for symmetric chest rise and bilateral breath sounds

Tracheal Airways

Endotracheal tubes are made of materials such as silicone, rubber, or PVC
Endotracheal tubes have markings indicating the depth of insertion and the distance from the patient's teeth
Features of the distal end of the EET include a bevel and a Murphy eye
Tube cuff design includes high-volume low-pressure (HVLP) and low-volume high-pressure (LVHP) cuffs, with complications including tracheal ischemia and stenosis
Specialized endotracheal tubes include preformed tubes, double-lumen tubes, and tubes with built-in suction channels
Tracheostomy tubes are used for long-term airway support and come in single and double lumen designs
Cuffed and cuff-less tracheostomy tubes are available, with the cuff inflating to prevent aspiration and promote secretion removal
The tracheostomy obturator is used to facilitate insertion and guide the tube into the trachea

Endotracheal Intubation

Indications for endotracheal intubation include acute respiratory failure, impending acute respiratory failure, securing the airway, and protecting the airway
Hazards and complications of endotracheal intubation include hypoxemia and hypercarbia, vagal stimulation, pharyngeal reflex stimulation, misplacement of the ETT, tooth fracture, and trauma to the lips, tongue, and pharyngeal tissues
Preventing complications involves preoxygenating the patient, minimizing procedure time, and avoiding excessive time without BVM support

Description

Explore the purpose and techniques of oropharyngeal suctioning and suctioning through an artificial airway, including hazards and clinical indications. Learn about the importance of suctioning in healthcare.