(a) Patients should be hyperoxygenated prior to suctioning and
between suction attempts by means of a ventilator or a manual resuscitator attached to
an oxygen flowmeter set at 100% oxygen.
This step limits the hypoxia caused by the suctioning.
(15) Insert the sterile suction catheter gently into the endotracheal tube
until resistance is felt, then pull back slightly.
(a) Suction should not be applied during catheter insertion to
prevent injury to the mucous membranes.
(b) The depth of suctioning may be determined by the physician's
order or by the health care facility's policy.
Place the thumb of your nondominant (nonsterile) hand over the
(17) Rotate the catheter between the thumb and index fingers of your
sterile hand while applying intermittent suction and withdrawing the catheter.
Do not suction for longer than 10 seconds.
(b) Secretions trapped near inflated endotracheal cuffs should be
removed at least every 8 hours by deflating the cuff and performing both oropharyngeal
and tracheal suctioning using appropriate techniques.
(c) Reinflate the cuff to the minimum occluding volume or
according to physician's order.
Rinse the suction catheter in sterile saline.
Instruct an assistant to hyperoxygenate the patient between suction
(20) Instill 5 cc of sterile normal saline into the trachea if ordered by the
physician and, if secretion is thick, wait 5 seconds and suction the patient again.
(a) Thick secretions may be controlled by instilling 5 cc of sterile
normal saline into the endotracheal tube immediately prior to suctioning.
Increasing airway humidity will also assist in liquefying
(21) Repeat the suction procedure until the airway is clear, rinsing the
catheter and hyperoxygenating the patient.