SUBGLOTTIC SUCTIONING | SUBGLOTTIC ASPIRATION | SUBGLOTTIC DRAINAGE

Summary

This educational video introduces subglottic suctioning, a critical procedure for removing secretions above the cuff of an endotracheal or tracheostomy tube in ventilated patients. It explains the importance of this technique in preventing ventilator-associated pneumonia (VAP) and outlines when and how to perform it, including manual and automated methods. The video emphasizes the need for suction in patients on mechanical ventilation over 72 hours and the use of a subglottic suction line for effective management.

Takeaways

• 😷 Subglottic suctioning is a technique used to remove secretions from above the cuff of an endotracheal or tracheostomy tube.
• 🔔 It's important to subscribe to the channel and enable notifications for instant updates on similar topics.
• 🌐 The process is crucial for preventing ventilator-associated pneumonia (VAP), also known as VAP Bundle.
• 💉 The suctioning is indicated for patients on mechanical ventilation for over 72 hours, especially when using a tube with a subglottic suction line.
• 🕒 Subglottic suction should be performed every two to four hours, depending on the volume of secretions.
• 🍼 A 5 ml syringe is typically used for the aspiration of secretions during subglottic suctioning.
• 👶 The frequency of suctioning may vary based on the amount of secretions: every four hours for less than 5 ml, and every two hours for more than 5 ml.
• 🛏️ Subglottic suction is also done before extubation, patient positioning, and before deflating the endotracheal tube cuff.
• 🔧 There are different methods of subglottic suctioning, including manual, continuous, intermittent, and automated intermittent suctioning.
• 🧰 Understanding the parts of the endotracheal tube, such as the evacuation port and the subglottic suction line, is essential for manual suctioning.
• 🤖 Automated intermittent subglottic suction devices offer a closed system that eliminates the need for manual suctioning and helps prevent cross-contamination.

Q & A

What is the main purpose of subglottic suctioning?

The main purpose of subglottic suctioning is to remove oropharyngeal secretions from above the cuff of the endotracheal or tracheostomy tube to prevent ventilator-associated pneumonia (VAP) and facilitate mechanical ventilation.

Why can't patients with an endotracheal tube naturally clear secretions above the cuff?

Patients cannot naturally clear secretions above the cuff because the endotracheal tube prevents glottic closure, which is necessary for the natural expulsion of secretions.

What is the potential consequence of inadequate endotracheal tube cuff pressure?

Inadequate cuff pressure may allow secretions to slip down into the trachea, potentially leading to ventilator-associated pneumonia.

Why is subglottic suction included in the VAP bundle?

Subglottic suction is included in the VAP bundle as one of the interventions to reduce the risk of ventilator-associated pneumonia by preventing the accumulation of secretions above the endotracheal tube cuff.

For whom is subglottic suction indicated?

Subglottic suction is indicated for patients requiring mechanical ventilation for more than 72 hours, and it is recommended that the endotracheal tube should have a subglottic suction line in such cases.

How often should subglottic suction be performed?

Subglottic suction should be performed every two to four hours using a 5 ml syringe, with the frequency adjusted based on the amount of secretions: every four hours if less than 5 ml, and every two hours if more than 5 ml.

When should subglottic suction be done before extubation?

Subglottic suction should be done before extubation to clear secretions from above the cuff and reduce the risk of aspiration.

What are the different methods of performing subglottic suction?

Subglottic suction can be performed manually, continuously, intermittently, or using an automated intermittent suction device.

What is the role of the evacuation port in the endotracheal tube during subglottic suctioning?

The evacuation port is an opening on the endotracheal tube used to connect to the subglottic suction line and aspirate the accumulated secretions.

How does an automated intermittent subglottic suction device improve patient care?

An automated intermittent subglottic suction device eliminates the need for manual suctioning, provides consistent suctioning, and helps maintain a closed system to prevent cross-contamination.

What is the importance of understanding the parts of the endotracheal tube before performing subglottic suction?

Understanding the parts of the endotracheal tube, such as the cuff, pilot balloon, and subglottic suction line, is crucial for correctly performing subglottic suction and ensuring patient safety.

Outlines

00:00

😷 Introduction to Subglottic Suctioning

This paragraph introduces the topic of subglottic suctioning, a technique used to remove secretions from above the cuff of an endotracheal or tracheostomy tube. It explains the importance of this procedure in preventing ventilator-associated pneumonia (VAP), also known as VAP bundle, and emphasizes the need for subscription and notifications for the channel. The video aims to educate about the accumulation of secretions and the risks associated with inadequate cuff pressure, which can lead to aspiration and pneumonia.

👨‍⚕️ Indications and Timing for Subglottic Suction

This section outlines when subglottic suction is necessary, specifically for patients on mechanical ventilation for over 72 hours, and the importance of having a subglottic suction line in the endotracheal tube for such cases. It details the frequency of suctioning, suggesting aspiration every two to four hours depending on the volume of secretions, and highlights additional times when suctioning should occur, such as before extubation, patient positioning, and cuff deflation.

🔧 Methods of Performing Subglottic Suction

The paragraph discusses various methods of performing subglottic suction, including manual suctioning with a syringe, continuous or intermittent suction devices, and automated intermittent suction systems. It provides an overview of the parts of an endotracheal tube relevant to suctioning, such as the evacuation port and the pilot balloon, and explains the process of manual suctioning using a 5ml syringe. Additionally, it mentions the benefits of automated devices in maintaining a closed system to prevent cross-contamination.

Keywords

💡Subglottic suctioning

Subglottic suctioning is a medical procedure used to remove secretions from the area above the cuff of an endotracheal or tracheostomy tube. This is crucial in the video's theme as it helps prevent ventilator-associated pneumonia (VAP) by clearing oropharyngeal secretions that can accumulate above the tube cuff and potentially seep into the lower respiratory tract. The script mentions this as an essential intervention in the VAP bundle.

💡Oropharyngeal secretions

Oropharyngeal secretions refer to the fluids and mucus that are produced in the mouth and throat. In the context of the video, these secretions can accumulate above the endotracheal tube cuff and may lead to aspiration, which is a significant concern for patients on mechanical ventilation.

💡Endotracheal tube

An endotracheal tube is a tube inserted into the trachea to facilitate mechanical ventilation. The video explains that the endotracheal tube prevents the natural glottic closure, which is necessary for the patient to clear secretions, leading to the need for subglottic suctioning.

💡Ventilator-associated pneumonia (VAP)

VAP is a type of pneumonia that patients can develop while on a mechanical ventilator. The video emphasizes the importance of subglottic suctioning as a preventive measure against VAP, as it helps to clear secretions that could otherwise lead to infection.

💡Cuff pressure

Cuff pressure refers to the pressure exerted by the inflated cuff of the endotracheal tube against the tracheal wall. The script mentions that inadequate cuff pressure can allow secretions to slip down into the trachea, increasing the risk of VAP.

💡Mechanical ventilation

Mechanical ventilation is the process of assisting or taking over the act of breathing for a patient who is unable to breathe adequately. The video discusses subglottic suctioning in the context of patients requiring mechanical ventilation for more than 72 hours, highlighting its importance in long-term ventilator care.

💡Subglottic suction line

The subglottic suction line is a feature of some endotracheal tubes that allows for the direct suctioning of secretions from above the cuff. The video script specifies that for patients on mechanical ventilation for over 72 hours, an endotracheal tube with a subglottic suction line is indicated.

💡Manual subglottic suctioning

Manual subglottic suctioning involves using a syringe to aspirate secretions from the subglottic suction port. The video describes this method, emphasizing the use of a 5 ml syringe and the frequency of aspiration based on the volume of secretions.

💡Automated intermittent subglottic suctioning

This refers to the use of a device that automatically performs subglottic suctioning at set intervals, eliminating the need for manual intervention. The video mentions this as an alternative to manual suctioning, providing a closed system to prevent cross-contamination.

💡Evacuation port

The evacuation port is an opening on the endotracheal tube used for suctioning secretions. The video script describes its location just above the cuff and its role in the manual subglottic suctioning process.

💡Pilot balloon

A pilot balloon is a small balloon that indicates the inflation status of the endotracheal tube's cuff. The video mentions it in the context of identifying the components of the endotracheal tube that are relevant to subglottic suctioning.

Highlights

Introduction to subglottic suctioning, a method for removing secretions above the cuff of an endotracheal tube.

Importance of subglottic suction to prevent ventilator-associated pneumonia (VAP).

Explanation of how oropharyngeal secretions accumulate above the endotracheal tube cuff.

Risk of aspiration and VAP due to inadequate endotracheal tube cuff pressure.

Subglottic suction as part of the VAP bundle intervention.

Necessity of subglottic suction during mechanical ventilation for over 72 hours.

Requirement for an endotracheal tube with a subglottic suction line for extended ventilation.

Frequency of subglottic suctioning every two to four hours.

Adjustments in suction frequency based on the volume of secretions.

Subglottic suction performed before extubation and patient positioning.

Demonstration of manual subglottic suctioning using a 5ml syringe.

Introduction to automated intermittent subglottic suction devices.

Advantages of automated devices in closed system suctioning to prevent cross-contamination.

Overview of the parts of an endotracheal tube relevant to subglottic suctioning.

Description of the evacuation port and its role in manual suctioning.

Different methods of performing subglottic suction: manual, continuous, and automated.

Conclusion and call to action for viewers to like, subscribe, and enable notifications for future content.

Transcripts

hello everyone welcome to yellow faces

nursing in today's video we will be

discussing about subglotti suctioning

before entering into the session if you

have not subscribed our channel please

subscribe our channel and do not forget

to hit the bell icon to receive instant

notifications

let's get into the topic

what do we mean by subglottic suction

subglottic suctioning is a method of

removing oropharyngeal secretions from

above the cuff of the endotracheal or

tracheostomy tube

when we look at this image here there is

oropharyngeal secretions above the cuff

the endotracheal tube prevents glottic

closure

as a result the patient is unable to

cuff and remove the secretions in a

natural way

hence there is accumulation or pulling

of oropharyngeal secretions above the

endotracheal tube curve

and this might lead to aspiration later

moreover

if the endotracheal tube cuff pressure

is not adequate the secretions may slip

down into trachea and this might lead to

ventilator associated pneumonia

otherwise called web

and hence subglottic suction is included

as one of the intervention in web bundle

now why is subglottic suction needed

in order to prevent ventilator

associated pneumonia that is wrap

and to reduce the ventilator this

during mechanical ventilation secretions

from the upper respiratory tract

accumulate above the endotracheal tube

cuff

studies have shown that these secretions

can seep

past the cuff into the lower tract

causing pneumonia

for whom do we need to do subclottic

suction

subclotic suction is indicated in

patients requiring mechanical

ventilation for more than 72 hours

and moreover when mechanical ventilation

is needed for more than 72 hours the

endotracheal tube should have a

subglottic suction line

next

when do we do subglottic suction

aspirate the subclottic port every two

to four hours using a 5 ml syringe

if the secretion is less than 5 ml then

the aspiration can done

every four hours and if the secretion is

more than five ml then the aspiration

can be done every two hours

then cyclotic suction is done before

extivation

and before positioning the patient

and furthermore before deflating the

endotracheal tube cuff

now how is subglottic suction done

there are many ways how we perform

subglottic suction

manuals of glottic suctioning continuous

or intermittent subglottic suction

automated intermittence of glottic

suctioning

now before discussing about manual

subglottic suctioning you should be

aware about the ethy tube parts

now when we look at this image the

patient is intubated with an et tube and

the cuff is inflated

just above the curve there is an opening

which we call as evacuation port

in order to suction the secretions

the oropharyngeal secretions are

accumulated above the cuff

and there is pilot balloon for inflating

the cuff

there are two lines one is for inflating

the cuff and one is for suctioning the

subglottic secretions

which is called as subglottic suction

line

now

what is manuals of glottic suctioning

manuals of glottic suctioning involves

placing a syringe into the subglottic

suction port to aspirate the secretions

as we discussed before a 5ml syringe is

used at the subglottic port

and the secretions are aspirated

now automated intermittence of glottic

suctioning

an automated intermittent subglottic

suction device eliminates the need for

manual suctioning of subglottic

secretions

it also provides the ability to suction

the patient in a closed system to

prevent cross contamination

so this is all about subglottic

suctioning

if you find this video useful please

like it and please subscribe it and do

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thanks for watching and have a nice day