Tracheostomy Suctioning- Nursing Skills

Summary

This instructional video outlines the procedure for suctioning a tracheostomy, emphasizing patient assessment before and after the process. It details setting up the suction equipment, preparing sterile water and gloves, and the technique of inserting and removing the suction catheter with intermittent suction. The video advises on the importance of monitoring oxygen saturation and lung sounds, and suggests a limit of three catheter passes per session, each not exceeding 10 seconds.

Takeaways

• 👨‍⚕️ Always assess the patient's lung sounds and oxygen saturation before and after suctioning.
• 🔌 Ensure the suction setup is working properly with tubing, canister, and regulator set on continuous medium suction.
• 📏 Prepare the suction kit by laying out the tubing within reach and loosening any oxygen devices.
• 🧤 Open the sterile water container and put on sterile gloves from the kit, ensuring they remain sterile.
• 🧪 Use the sterile gloves to open the cardboard water container and set it up on the sterile field.
• 🌀 Hold the suction catheter with your dominant hand and wrap it around your hand to grasp the plastic end.
• 💧 Pour sterile water into the container with your non-dominant hand, then connect the suction tubing to the catheter.
• 🚫 Slowly insert the catheter into the tracheostomy until resistance is met, then apply intermittent suction while twisting.
• 🔄 After removing the catheter, consider whether another pass is needed, and clean the catheter if secretions are thick.
• 🚫 Limit catheter passes to three per session and do not exceed 10 seconds per pass.
• 👂 After suctioning, check the patient's oxygen saturation and lung sounds to ensure improvement.

Q & A

What is the purpose of suctioning a tracheostomy?

Suctioning a tracheostomy is done to remove secretions from the airway to ensure the patient's breathing is not obstructed.

When should you assess the patient's lung sounds and oxygen saturation?

You should assess the patient's lung sounds and oxygen saturation before and after suctioning to monitor their condition.

What should you check before starting the suctioning process?

Before starting, ensure the suction setup is working properly, including the tubing, canister, and regulator set on continuous medium suction.

How should you position the suction tubing?

The tubing should be laid over the head of the bed or on the patient's chest to ensure it is easily reachable.

Why might you loosen an oxygen device before suctioning?

Loosen an oxygen device to allow for easier insertion of the suction catheter and to prevent obstruction during the procedure.

What items should be included in the suction kit?

The suction kit should include sterile gloves, suction tubing, the suction catheter itself, and a cardboard water container.

How should you handle the sterile gloves to maintain sterility?

Handle the sterile gloves carefully, ensuring that only your sterile hands touch the catheter, and use the package as a sterile field if necessary.

What is the purpose of the sterile water in the suctioning process?

Sterile water is used to moisten the suction catheter and to clean it out if the secretions are thick.

How do you connect the suction tubing to the catheter?

You connect the suction tubing to the plastic part of the suction catheter using your non-dominant hand, ensuring your sterile hand does not touch anything non-sterile.

What is the proper technique for inserting the catheter during suctioning?

Insert the catheter into the tracheostomy until the patient coughs or you meet resistance, then apply intermittent suction while twisting the catheter on its way out.

How many times can you pass the catheter, and what is the maximum duration per pass?

You can do up to three passes with one catheter, with no more than 10 seconds per pass.

What should you do after completing the suctioning process?

After suctioning, ensure the patient's oxygen saturation has improved, listen to their lungs to confirm the secretions have been removed, and dispose of the catheter properly.

Outlines

00:00

🩺 Suctioning a Tracheostomy: Preparation and Technique

This paragraph outlines the process of suctioning a tracheostomy, a procedure necessary for patient care. The video emphasizes the importance of assessing the patient's lung sounds and oxygen saturation levels before and after the procedure. The setup includes a suction machine with continuous medium suction, tubing, and a canister. The nurse is instructed to prepare the sterile water container and suction kit, including gloves, tubing, and catheter. The catheter is prepared by wrapping it in a sterile manner around the nurse's hand and connecting it to the suction tubing. The actual suctioning involves inserting the catheter until resistance is met or the patient coughs, then applying intermittent suction while twisting the catheter as it's removed. After suctioning, the nurse should check the patient's oxygen levels and lung sounds to ensure the procedure was effective. The video concludes with a reminder to practice these skills for proficiency.

Keywords

💡Suctioning

Suctioning refers to the process of removing fluids or secretions from a body cavity, such as the lungs or airways. In the context of the video, suctioning is a critical procedure performed on patients with a tracheostomy to clear their airways. The script mentions that suctioning may be done before tracheostomy care or when the patient requires it, emphasizing its importance in patient care.

💡Tracheostomy

A tracheostomy is a surgically created opening in the trachea, commonly performed to assist in breathing. The video discusses the procedure of suctioning in the context of a tracheostomy, indicating that this is a specialized form of suctioning that requires specific techniques and precautions to ensure patient safety and comfort.

💡Sterile

Sterile refers to the absence of any living microorganisms, which is crucial in medical procedures to prevent infection. The video script emphasizes the use of sterile gloves and sterile water, highlighting the importance of maintaining sterility throughout the suctioning process to protect the patient from potential infections.

💡Oxygen Saturation

Oxygen saturation is a measure of the amount of oxygen carried by red blood cells, expressed as a percentage. The video script mentions checking oxygen saturation before and after suctioning, indicating that this is a vital parameter to monitor the patient's respiratory status and the effectiveness of the suctioning procedure.

💡Suction Setup

A suction setup refers to the equipment and connections needed to perform suctioning. The script describes a setup that includes tubing, a canister, and a regulator set on continuous medium suction, which is essential for effectively removing secretions from the tracheostomy.

💡Suction Catheter

A suction catheter is a long, thin tube used to remove fluids or secretions from the body. In the video, the catheter is wrapped around the hand to facilitate its insertion into the tracheostomy and the application of suction, demonstrating its role in the suctioning process.

💡Intermittent Suction

Intermittent suction refers to the application of suction in short bursts rather than continuously. The video script instructs to apply intermittent suction while twisting the catheter on its way out, which helps to remove secretions more effectively without causing unnecessary trauma to the patient's airways.

💡Lung Sounds

Lung sounds are the noises produced by the respiratory system during breathing. The video script advises assessing lung sounds before suctioning and then re-assessing afterward to confirm that the procedure has been effective in clearing secretions and improving respiratory function.

💡Sterile Water

Sterile water is water that has been treated to remove any microorganisms. The script mentions using sterile water to clean the suction catheter if secretions are thick, illustrating its use in maintaining hygiene and facilitating the suctioning process.

💡Oxygen Device

An oxygen device is any piece of equipment used to deliver oxygen to a patient. The video script suggests loosening any oxygen device before suctioning, which is important to ensure that the patient can still receive oxygen during the procedure and to prevent dislodging the device.

💡Secrecy

Secrecy in this context refers to the presence of thick or excessive mucus in the respiratory tract. The script discusses the possibility of suctioning sterile water through the catheter to clean it out if secretions are super thick, indicating the need for additional measures to manage such secretions.

Highlights

The necessity of assessing the patient's lung sounds and oxygen saturation before and after suctioning.

Ensuring the suction setup is working properly with the correct tubing and regulator settings.

Setting the suction to continuous medium level.

Laying out the tubing for easy reach during the procedure.

Loosen any oxygen devices before starting the suctioning process.

Opening the sterile water container and setting it on the table.

Putting on sterile gloves from the suction kit.

The importance of maintaining sterility when handling the suction catheter.

Using the sterile gloves package as a sterile field if needed.

Preparing the suction catheter by wrapping it around the hand.

Connecting the suction tubing to the catheter with sterile technique.

Inserting the catheter into the tracheostomy until resistance is met.

Applying intermittent suction while twisting the catheter on the way out.

Holding the catheter away from the patient to maintain sterility after use.

Deciding whether another pass with the catheter is necessary based on secretion thickness.

Using sterile water to clean the catheter if secretions are thick.

Limiting the number of passes with one catheter to three and the duration of each pass to no more than 10 seconds.

Checking the patient's oxygen saturation and lung sounds after suctioning to ensure improvement.

Encouraging practice to improve nursing skills.

Invitation to watch more lessons on nursing.com for further learning.

Transcripts

[Music]

in this video we're going to talk about

suctioning a tracheostomy now you may

need to do this before you do trait care

or just because the patient requires

suctioning just make sure that you

assess the patient before you start so

that you know what their lung sounds are

and what their oxygen saturation is

before and after suctioning

so first thing you want to do is make

sure your suction setup is working you

should have tubing attached to a

canister attached to a regulator for

this you want to set it on continuous

medium suction you also want to make

sure that you can reach the end of the

tubing sometimes i just lay it over the

head of the bed or on the patient's

chest you can also loosen any

oxygen device that they have at this

point so the first thing you want to do

is open your sterile water container and

just set the bottle on the table between

you and the suction kit

now you can open your suction kit

and put on your sterile gloves from in

that kit now honestly sometimes they're

all bunched up and sometimes they have

their own package so depending on your

kit just be really careful to make sure

that you keep them sterile now in this

little kit what you should have is the

sterile gloves

the suction tubing the suction catheter

itself and a little cardboard water

container

so once you get your gloves on

you want to open that little cardboard

water container

inside that sterile package

and set it up on your sterile field

now sometimes especially if i get

another package of gloves i'll actually

use my sterile gloves package as my

sterile field here so open your little

cardboard water container

and the next thing you want to do is

grab the suction catheter in your

dominant hand put the tip downwards and

wrap it backwards around your hand that

way you can grab onto the plastic end of

the suction canister

now with your non-dominant hand you can

grab the sterile water pour some sterile

water into the container remember that

hand is no longer sterile grab the

suction tubing and connect it to the

plastic part of the suction catheter

being careful that only your sterile

hand touches the catheter

now at this point you are ready to

suction

so use your non-dominant hand to move

any oxygen mask if you have it and with

the same hand you're going to use to

control the suction port with your thumb

so you're going to slowly insert the

catheter into the tracheostomy until the

patient coughs or you meet resistance

and then you're going to apply apply

intermittent suction while you twist the

catheter on its way out

once you're out hold that catheter away

from the patient to keep it sterile

replace their oxygen source with your

non-dominant hand if you need to and

decide whether or not you think they

need another pass now if the secretions

were super thick you can actually

suction some of that sterile water

through the catheter to clean it out

now you can do up to three cat passes

with one catheter but no more than 10

seconds per pass so again insert the

catheter

and remove while applying intermittent

suction and twisting the catheter

this just helps that we get all the

secretions off of the edge

when you're done you can wrap it up in

your hand

again make sure that you see the

patient's oxygen saturation is improved

and then

you always want to listen to their lungs

again to make sure that you've actually

made a difference and gotten the

secretions out that you wanted

all right guys i hope that was helpful

the more that you practice these skills

the better you'll get at them all right

go out and be your best selves today

guys and as always happy nursing thanks

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