Respiratory Care Science 2 - Suctioning (PDF)

‫كليـــــة ابن سيـــــــــــــرين للعلوم الطبية‬ Collage of Ibn sereen For Medical Sciences Respiratory Care Science 2 Suctioning 2ed year respiratory therapist student Dr:MOHAMMED-SENAN BS, RCP, MsRC December 24 21-Dec...

‫كليـــــة ابن سيـــــــــــــرين للعلوم الطبية‬ Collage of Ibn sereen For Medical Sciences Respiratory Care Science 2 Suctioning 2ed year respiratory therapist student Dr:MOHAMMED-SENAN BS, RCP, MsRC December 24 21-Dec-24 DR:MohammedDrMohammmed Senan MsRCSenana 1 1  Airway Clearance (Suctioning) December 24 DR:Mohammed Senan MsRC 2 December 24 DR:Mohammed Senan MsRC 3 Outlines 1. Terminology 2. Definition of suctioning. 3. Sites for suction. 4. Difference between oropharengyeal / nasopharyngeal suctioning and endotracheal / tracheostomy suctioning. 5. Purposes for suctioning. 6. Indications for suctioning. 7. Choosing the right size catheter. 8. Setting the correct pressure. 9. Documentation. 10.Complications December 24 of suctioning DR:Mohammed Senan MsRC 4 Terminology Airway Suction: The removal of airway secretions/foreign material by artificial means, using an applied negative pressure Yankauer Suction Catheter: A rigid suction tip used to aspirate secretions from the oropharynx Oropharyngeal Suction: (OP) requires the use of an airway adjunct (Guedel Airway) Suction is an invasive procedure and should NOT be carried out on a routine basis. But, suctioning is an integral part of the management of intubated December 24 /ventilated patients. DR:Mohammed Senan MsRC 5 Definition Nasopharyngeal Suction: (NP) may be undertaken directly via the nostril without an airway adjunct. If repeated suction is anticipated a nasopharyngeal airway should be utilised. This is inserted only by those that are trained to do so. Suction. Is 'the mechanical aspiration of pulmonary secretions from a patient with an artificial airway in place'. The procedure involves patient preparation, the suctioning event(s) and follow-up care December 24 DR:Mohammed Senan MsRC 6 Sites for Suctioning December 24 DR:Mohammed Senan MsRC 7 Rigid Yankuer Suction Tube December 24 DR:Mohammed Senan MsRC 8 Sites for Suctioning Nasopharyngeal December 24 DR:Mohammed Senan MsRC 9 Sites for Suctioning Tracheostomy December 24 DR:Mohammed Senan MsRC 10 Sites for Suctioning Endotracheal. December 24 DR:Mohammed Senan MsRC 11  Difference between Oropharyngeal /Nasopharyngeal suctioning and Endotracheal/ tracheostomy suctioning Oropharyngeal Endotracheal/Tracheostomy /Nasopharyngeal suctioning suctioning Remove secretion from the Remove secretion from the upper respiratory tract. trachea and bronchi or the lower respiratory tract. December 24 DR:Mohammed Senan MsRC 12  Purposes Of Suctioning :- Oral / Nasal suction 1-maintain oral/ nasal hygiene. 2-comfort for the patient. 3- remove blood and vomit in an emergency situation. December 24 DR:Mohammed Senan MsRC 13  Purposes Of Suctioning :- Tracheal/ Endo-tracheal suction To maintain a patent airway by removing retained tracheobroncheal secretions. To prevent lower respiratory tract infection from retained secretions. To provide effective ventilation. To stimulate coughing. December 24 DR:Mohammed Senan MsRC 14  Indication Therapeutic Diagnostic December 24 DR:Mohammed Senan MsRC 15 Therapeutic Indications  Noisy breathing  Visible secretions in the airway  Decreased SpO2 in the pulse oximeter & Deterioration of arterial blood gas values  Patient’s inability to generate an effective spontaneous cough  Presence of pulmonary atelectasis or consolidation, presumed to be associated with secretion retention  During special procedures like Bronchoscopy& Endoscopy December 24 DR:Mohammed Senan MsRC 16 Diagnostic Indications Indication  The need to obtain a sputum specimen / ETA(Endo Tracheal Aspiration) for investigations. December 24 DR:Mohammed Senan MsRC 17 Choosing the right size catheter Age Size Adult #12 to #18 Children #8 to # 10 Infant # 5 to #8 OPAs are made in various sizes. The correct size OPA should track from the corner of the patient's mouth to the angle of the jaw. Insertion of an OPA of incorrect size may push the tongue back toward the pharynx creating an obstruction. December 24 DR:Mohammed Senan MsRC 18 Choosing the right size catheter Estimating NPA length by measuring the distance from the tip of the nose to the tragus of the ear has not been validated in adults. A study in Chinese children found a close association between nares-vocal cord distance and nose tip-earlobe distance, with the ideal NPA length being slightly less than this anthropometric measurement December 24 DR:Mohammed Senan MsRC 19 Setting the Correct Pressure Age Wall Unit Portable Unite Adult 100 to 120 mm Hg 10 to 15 mm Hg Child 95 to 110 mm Hg 5 to 10 mm Hg Infant 50 to 95 mm Hg 2 to 5 mm Hg December 24 DR:Mohammed Senan MsRC 20  Types of ET Suctioning Closed SUCTION Open SUCTION - Do not disconnect from ventilator. Similar procedure - Clearing the airways of a to open technique but no application of sterile glove mechanically ventilated patient - Enables a clinician to clear the lungs of secretions with a suction catheter inserted whilst maintaining ventilation and minimising into the endotracheal tube after contamination with the least possible disruption to the the patient has been dis patient connected from the ventilator circuit - Helpful in preventing cross contamination and infection December 24 DR:Mohammed Senan MsRC 21 Types of ET Suctioning: Closed SUCTION December 24 DR:Mohammed Senan MsRC 22 Patient Preparation Explain the procedure to the patient if conscious. The patient should receive hyper oxygenation by the delivery of 100% oxygen for >30 seconds prior to the suctioning Position the patient in supine position. Auscultate the breath sounds. December 24 DR:Mohammed Senan MsRC 23  ASSESSMENT Patient should be monitored prior to, during & after the procedure for following :  Breath sounds & Oxygen saturation Respiratory Rate & pattern Hemodynamic parameters (pulse rate, Blood pressure) Cough effort ICP (If indicated and available) Sputum characteristics (color, volume, consistency & odor) Ventilator parameters (PIP, Vt & FiO2) December 24 DR:Mohammed Senan MsRC 24 EQUIPMENT ASSEMBLYING 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 December 24 DR:Mohammed Senan MsRC 25 Documentation The amount. Record the procedure : Consistency. Color. Odor of the mucus. Client breathing status before and after. December 24 DR:Mohammed Senan MsRC 26 COMPLICATIONS Hypoxia Tracheal or bronchial mucosal trauma Cardiac or respiratory arrest Pulmonary hemorrhage / bleeding Cardiac dysrhythmias Pulmonary atelectasis Bronchospasm Hypotension / hypertension December Elevated24 ICP DR:Mohammed Senan MsRC 27  References: December 24 DR:Mohammed Senan MsRC 28  Have a great day December 24 14, 2024 Sunday, January DR:Mohammed Senan MsRC 29 112