Performing Nasotracheal and Nasopharyngeal Suctioning

Summary

This instructional script provides a detailed guide on performing nasotracheal suctioning, including preparation, patient positioning, equipment setup, and the step-by-step procedure for safe and effective suctioning. It emphasizes the importance of patient assessment, proper suctioning techniques, and post-procedure care, including documentation and follow-up assessment. The guide ensures that healthcare providers perform the procedure with proper infection control measures, adequate patient monitoring, and respect for privacy, safety, and comfort throughout the process.

Takeaways

• 😀 Verify patient has no contraindications (e.g., bleeding disorders, epiglottitis, laryngospasm) before starting nasotracheal suctioning.
• 😀 Perform hand hygiene, ensure patient privacy, and introduce yourself to the patient.
• 😀 Identify the patient using two identifiers, and place a pulse oximeter on the patient's finger.
• 😀 Position the patient in a semi-Fowler's position or help them sit up for easier breathing.
• 😀 Wear appropriate PPE (mask, goggles, face shield) if splashing is likely during the procedure.
• 😀 Connect the suction tubing to the machine and check that the suction pressure is set to the lowest effective level.
• 😀 Prepare the suction catheter using aseptic technique and ensure sterile saline or water is available for use.
• 😀 Apply water-soluble lubricant to the catheter's distal end and gently insert it into the patient’s nostril during inhalation.
• 😀 If resistance is encountered, withdraw the catheter slightly before applying suction to avoid hitting the Carina.
• 😀 Limit suction passes to a maximum of two, ensuring adequate time (at least 1 minute) between passes for ventilation and oxygenation.
• 😀 After suctioning, rinse the catheter and tubing with saline, dispose of used materials properly, and perform post-procedure documentation.

Q & A

What are the contraindications to nasotracheal suctioning?

Contraindications include conditions such as bleeding disorders, epiglottitis, and laryngospasm.

Why is it important to perform hand hygiene before starting the procedure?

Hand hygiene is crucial to prevent the spread of infection and ensure the safety of both the patient and the healthcare provider.

What should you do to prepare the patient for nasotracheal suctioning?

Ensure the patient is in a semi-Fowler's or sitting position, place a pulse oximeter on their finger, and instruct them to breathe deeply and slowly.

What is the recommended pressure setting for the suction device?

The suction device should be set to the lowest pressure level possible that will effectively clear secretions.

How should the suction catheter be prepared before use?

Open the suction kit using aseptic technique, fill the tray with sterile normal saline or sterile water, and lightly coat the distal end of the catheter with water-soluble lubricant.

What is the general rule for inserting the catheter depth during nasopharyngeal suctioning?

The catheter should be inserted to approximately the same depth as the distance from the mouth or tip of the nose to the angle of the mandible.

How should the suction catheter be inserted into the patient's nose?

Gently insert the catheter into one of the nostrils while the patient inhales, following the natural course of the nare, and orient the catheter downward slightly.

What should be done if resistance is felt when inserting the catheter?

If resistance is felt, this likely means the catheter has reached the Carina. Withdraw the catheter 1 to 2 centimeters before applying suction.

How long should suction be applied when performing the procedure?

Suction should be applied intermittently or continuously for no more than 15 seconds, while slowly withdrawing the catheter.

What is important to monitor after completing the suctioning procedure?

Monitor the patient's cardiopulmonary status and ensure their blood oxygen level has returned to baseline. Also, assess for the need to repeat the procedure and document the pre- and post-suctioning findings.