b. Nasopharyngeal Route. If the patient is uncooperative (clenches his teeth,
bites, or chews the catheter), nasopharynx suctioning may be required to remove
secretions from the back of the throat. This procedure is also used to remove
secretions from the nose.
(1) Estimate the maximum distance the catheter is to be inserted. Do this
by measuring from the tip of the patient's ear to his nose.
Insert the suction catheter into one of the patient's nostrils without using
(a) Generally, it is easier to insert a catheter into the right nostril than
into the left, due to a lower incidence of septal deviation (a deformity of the wall
separating the two nasal cavities, causing a partial or complete blockage of the nostril).
(b) If an obstruction is met, remove the catheter and try the left nostril.
(c) If an obstruction is still met, remove the catheter and obtain
assistance from your supervisor or other appropriate personnel.
(3) Advance the catheter quickly and gently about 3 to 5 inches (but no
more than the estimated maximum distance) into the nostril without using suction.
(4) Apply suction by placing the thumb of the non-sterile hand over the
suction port. Suction for no more than 15 seconds
(5) Withdraw the catheter using a rotating motion. This prevents sucking
mucous membrane tissue into the catheter.
(6) Clear the catheter by inserting the tip in the sterile solution and suction
the solution through the catheter.
(7) Repeat these procedures until the secretions have been aspirated and a
patent airway restored. Allow the patient to rest between suctioning and re-oxygenate
the patient before each suctioning.
c. Nasotracheal Route. Nasotracheal suctioning is similar to nasopharyngeal
suctioning with deeper (trachea) suctioning being accomplished.
(1) Estimate the distance the catheter is to be inserted. Do this by
measuring from the patient's nose to the tip of his ear, then to his larynx.
Lubricate the tip of the catheter by dipping it into the basin of sterile