(5) Personal observations. One or more of the following observations in a
patient indicate a need for suctioning:
(a) Increased respirations accompanied by labored or difficult
Moist, noisy, rattling, or gurgling sounds while breathing.
Secretions drooling from the mouth and/or nose.
The physician's orders, nursing care plan, or the supervisor's directive will
dictate the frequency of suctioning, usually p.r.n. (as needed).
b. Perform a Patient Care Handwash. When suctioning, every effort must be
made to prevent the introduction of pathogens into the lower airways. Clean technique
and thorough handwashing are essential for suctioning of the oral and nasal cavities.
Sterile technique is mandatory for deep suctioning in the tracheobronchial tree and
suctioning through the endotracheal and tracheostomy tubes. Follow aseptic
techniques for all suctioning of the airway in order to minimize the spread of
microorganisms that are not normally found in the air passages.
c. Obtain the Necessary Equipment. Obtain the following equipment.
(1) Disposable suction equipment set. If such a set is not available,
assemble the following:
(a) Sterile, disposable suction catheters. (Catheters are sized using
the French scale: the smaller the number, the smaller the catheter. For example, 12 is
smaller than 14 by this scale. These two catheter sizes are the most commonly used
for suctioning the adult patient.)
(b) Liter flask of sterile saline or water.
Sterile solution basin.
(d) Sterile gloves.
(2) Suction apparatus. Suctioning of the airway requires a source of
vacuum. Most hospitals that have piped-in oxygen also have a piped-in vacuum
source. When a piping system is not available, portable suction units must be used.
Most portable suction used in hospitals units must be connected to an electrical source.
Many portable units designed for field use, however, obtain their power from
compressed gas (air, oxygen, or Freon) cylinders and do not need electrical power.
Figure 4-1 shows two types of suction devices.