(3) Instruct the alert, cooperative patient to flex his head and stick out the
tongue. This helps to keep the patient from swallowing and makes the catheter
(4) Gently insert the suction catheter into the nasopharynx without
suctioning. (Remember, it is usually easier to insert the catheter into the right nostril.) If
the catheter cannot be inserted into the nasopharynx through either nostril, remove the
catheter and obtain assistance from your supervisor or other appropriate personnel.
(5) Quickly and gently advance the catheter into the trachea (figure 4-4).
The insertion process may cause the patient to cough. Mild coughing is usually not a
problem and may actually help in the insertion process.
Figure 4-4. Inserting catheter using nasotracheal route.
A Patient sticking out tongue. B Insertion completed.
(6) Suction secretions by placing the thumb over the suction port. Suction
the patient for approximately 15 seconds.
(7) Observe the patient throughout the procedure for color change or
increased pulse rate. Pulse rate increases with hypoxemia. Listen for changing breath
sounds. As secretions are removed, breathing should become quiet again. Discontinue
suctioning if severe changes in color or pulse occurs.
(8) After suctioning, remove your thumb from the suction port and withdraw
the catheter using a slow, rotating motion.