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Definition -:

Oronasopharyngeal suction removes secretions from the pharynx by a suction catheter inserted through the mouth or nostril.

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To maintain a patent airway ,

This procedure helps the patient who can’t clear his airway effectively with coughing

Such as the unconscious or severely debilitated patient.

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Oronasopharyngeal suction is an aseptic procedure that requires sterile equipment.

Nasopharyngeal suctioning should be used with caution in patients who have

-Nasopharyngeal bleeding -Spinal fluid leakage into the

nasopharyngeal area , -Receiving anticoagulant therapy,

because these conditions increase the risk of bleeding .

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1.Oropharngel

2.Naspharngel

3.Tracheostomy & end tracheal tubes

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Equipment

•Portable suction apparatus•Collection bottle•Connection tubing •Water-soluble lubricant •Normal saline solution

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- Disposable sterile container- 12 – 14 French catheter for an adult- For an child 8 – 10 French catheter - For pediatric feeding tube for an infant - Sterile gloves - Clean gloves - Nasopharyngeal or oropharyngeal airway

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Before beginning,

1. Check your facility's 2. Doctor’s order3. Review the patient’s blood gas 4. Check vital signs 5. Evaluate the patient’s ability to cough

& deep-breathe to determine her ability to move secretions

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• Explain the procedure to the patient even if she is unresponsive

• Inform her that suctioning may stimulate transient coughing or gagging {but tell her that coughing helps to mobilize secretions}

• Reassure her throughout the procedure to minimize anxiety & fear which can increase oxygen consumption

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• Wash your hands

• Place the patient in semi-fowler's or high fowler’s position, to promote

• lung expansion & effective coughing • Turn on the suction from the

portable unit,

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• Set the pressure according to your facility's policy

The pressure is usually set between 80 & 120 mm hg; (higher pressure cause excessive trauma without enhancing secretion removal.)

Occlude the end of the connection tubing to check suction pressure.

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• Using strict aseptic technique, open the suction catheter kit

• Disposable container & gloves

• Consider your dominant hand sterile & your non dominant hand non sterile

• Using your non dominate hand, pour the sterile water or saline into the sterile container

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-With your non dominant hand, place a small amount of water- soluble lubricant on the sterile area.

-The lubricant is used to facilitated passage of the catheter during nasopharyngeal suctioning.

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• Pick up the catheter with your dominant (sterile) hand, & attach it to the connecting tubing

• Use your non dominant hand to control the suction valve while your dominant hand manipulates the catheter.

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• Instruct the patient to cough & breathe slowly & deeply several times before beginning suction. Coughing helps loosen secretions & may decrease the amount of suctioning necessary,

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Suction tracheal tubes 1. Explain procedure

to patient 2. Collect equipment 3. Wash hands 4. Provide privacy 5. Elevate bed to

working level

6. Put down side rail 7. Place patient in

fowler position 8. Open & prepare

sterile field, supply 9. Urn on suction

machine & check pressure

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• Never suction more than 10 seconds at a time to prevent hypoxia

• Do not apply suction pressure during insertion catheter

• Pre-oxygenated the patient

• Wait 3 minutes interval before each suction

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followed by hypotension related to stimulation of vague nerve

• Use genital insertion & manipulation of catheter

• Lubricate catheter before to inserting

• Monitor pt’s pulse

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• Follow strict aseptic technique

• Suction patient only when needs

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Record for

1. Date, time 2. Amount, color, consistency &

odor

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