ORAL, NASOPHARYNGEAL, AND NASOTRACHEAL SUCTIONING
a. Suctioning is a common nursing activity performed for the purpose of
removing accumulated secretions from the patient's nose, mouth, and/or
tracheobronchial tree in order to maintain a patent (open) airway as well as to remove
lung secretions that block gaseous exchange. Removal of these secretions can be
carried out through the oropharyngeal (mouth and pharynx), nasopharyngeal (nose and
pharynx), or nasotracheal (nose, pharynx, and trachea) routes. Artificial airways, such
as an endotracheal tube (a tube inserted into the trachea through the nose or mouth) or
a tracheostomy tube (a tube inserted through a surgical incision into the trachea), can
also be used as routes for suctioning.
b. Suctioning is performed on patients who have lost control of their ability to
swallow and to cough up secretions due to a stroke, unconsciousness, or disease
process. The procedure should be performed ONLY when needed. Frequent
suctioning causes trauma to the mucous linings of the respiratory tract and can result in
hemorrhage and edema. Nasotracheal suctioning can also cause hypoxemia,
infections in the lungs (pneumonia), atelectasis (collapsed lung), and cardiac arrest.
c. It is desirable to have the patient manage his own secretions. Postoperative
patients must be turned and encouraged to cough and deep breathe frequently (usually
every two hours) following surgery. This practice will be helpful in preventing
postoperative complications such as pneumonia and reducing the need for suctioning.
d. When more than one route is used, either route may be performed first.
Whenever the route is changed, however, the used catheter and gloves are discarded
and a new catheter and new gloves are used for the new route. Sterile technique must
be is used for all nasotracheal suctioning to prevent the introduction of "foreign"
organisms (including numerous organisms normally found in the nose and pharynx) into
PROCEDURES PERFORMED PRIOR TO SUCTIONING
a. Verify Need for Suctioning. The need for suctioning can be determined
from the following sources.
Nursing Care Plan.
The supervisor's directive.