Suctioning Flashcards
(48 cards)
1
Q
what is suctioning?
A
- mechanical aspiration of pulmonary secretions from a patient with an artificial airway
2
Q
why is open suctioning via guedel airway performed? (2)
A
- effectively clears secretions
- maintains airway patency
3
Q
when should open suctioning only be performed?
A
- if less invasive techniques have been unsuccessful
4
Q
when is oral pharyngeal suctioning indicated? (8)
A
- new or increased 02 requirements
- decreased oxygen saturation
- inability to cough and self-void secretions
- increased respiratory rate
- evidence of retained secretions on auscultation
- muffling of a patient’s voice by secretions
- moist, rattling cough
- reduced airway tone
5
Q
how is the OPA size tracked?
A
- from the corner of the patient’s mouth to the angle of the jaw
6
Q
what happens if the incorrect size OPA is inserted?
A
- may push the tongue back towards the pharynx creating an obstruction
7
Q
how is the OPA inserted into children? what does it use?
A
- airway is inserted the right way up using a tongue depressor
8
Q
what should you do before inserting the oropharyngeal airway?
A
- open the patient’s mouth to ensure there is no foreign material that may be pushed
9
Q
what position is the head in when inserting the oropharyngeal airway?
A
- head- tilt chin lift
10
Q
which way do you insert the oropharyngeal airway?
A
- insert upside down
11
Q
how do you know when to stop pushing the oropharyngeal airway? what do you do once you’ve reached this?
A
- stop when you reach the junction of the hard and soft palpate
- then rotate 180 degrees
12
Q
what does oropharyngeal suctioning help to maintain? how?
A
- maintains adequate oxygenation by provided an avenue for adequate ventilation
13
Q
what could over-suctioning cause? (2)
A
- could cause mucosa or trauma
14
Q
what should you always think about before suctioning?
A
- pre- oxygenation if patient is desaturating
15
Q
what should you do before connecting the catheter to the suction tubing?
A
- ensure you have a sterile glove on your dominant hand
16
Q
what is the ideal pressure of open suctioning for an adult?
A
- 100 to 150mmHg
17
Q
how do you insert the catheter into the guedel airway?
A
- insert gently until 10-15cm deep
18
Q
what do you do once the catheter is in?
A
- withdraw the catheter applying suction
19
Q
what time is the catheter limited to?
A
- limited to <10-15 seconds
20
Q
what 4 factors should be re-assessed after open suctioning?
A
- SP02
- breathing pattern
- colour
- respiratory rate
21
Q
what are the 5 findings you would document after open suctioning?
A
- time
- amount
- consistency
- color
- odor of mucus
22
Q
how long should you allow in-between each suction?
A
- 20 to 30 second intervals
23
Q
how do you know that open suctioning has improved outcomes? (4)
A
- improved breath sounds
- decreased WOB
- improvement in ABGs
- removal of pulmonary secretions
24
Q
what are the 4 contraindications of open suctioning?
A
- pharyngeal obstruction
- acute pulmonary oedema
- acute bleeding in oropharynx
- known base of skull fracture
25
what are the precautions of open suctioning? (7)
- facial/ oral trauma
- bleeding risk
- haemodynamic instability
- haemoptysis
- children
- false teeth
- recent oral surgery
26
what are the complications that may arise post open suctioning? (10)
- trauma to the airway
- bleeding
- vomiting and aspiration
- transient bradycardia
- airway obstruction
- hypoxemia
- cardiac dysthymias
- nosocomial infection
- dental trauma
- stimulation of a biting reflex
27
where does the guedel airway remove secretions from?
- removes secretions from the upper respiratory tract
28
where does endotracheal suctioning remove secretions from? (2)
- trachea and bronchi or the lower respiratory tract
29
what is the difference between open and closed suctioning?
- open performed while disconnected from a ventilator whereas closed happens while still attached to the ventilatory circuit
30
what is closed suctioning via endotracheal tube?
- method used to clear secretions of mechanically ventilated patients without disconnecting the patient from the ventilator
31
what are the 3 benefits of closed suctioning via ETT?
- maintains airway patency
- optimises oxygenation
- prevents complications
32
what is closed suctioning via ETT suitable for?
- patients requiring high oxygen and PEEP levels
33
what is the closed suction system helpful in preventing? (2)
- cross contamination
- infection
34
what two risks are minimised in the closed suction system?
- hypoxia
- lung volume loss
35
what are the indications of closed suctioning? (10)
- visible, audible or auscultated ETT secretions
- increasing ventilator peak pressure
- decreased tidal volumes
- new or increased SP02 requirements
- inability to cough and self-void secretions
- increased respiratory rate
- increasing C02 and/ or decreasing SP02
- suspected aspiration
- history of thick ETT secretions
- concern that the ETT is blocked or no longer patent
36
what is the correct sized suction catheter?
- double the size of the ETT
37
what should you do before closed suctioning? what does his minimise?
- preoxygenate patient by connecting the oxygen source at 100% Fi02 for 30-60seconds to minimise hypoxia during suctioning
38
what is the position used in closed suctioning?
- fowler's position
39
what is the fowler's position? what does it promote
- head slightly elevated to promote optimal lung expansion
40
what other optimal position can you use for closed suctioning?
- high half sitting between 35 to 45 degrees
41
how far should you insert the suction catheter into the ET?
- until resistance is felt, indicating you have hit the carina
42
how do you withdraw catheter in closed suction?
- withdraw while applying intermittent suctioning
43
what is suctioning limited to?
- 10 to 15 seconds
44
what may need to be administered after suctioning? why?
- supplemental oxygen
- needed to maintain oxygen saturation
45
what comfort measures can you take post suctioning? (2)
- oral care
- repositioning
46
what does repositioning prevent?
- prevents complications like pressure scores
47
what are the potential complications of closed suctioning? (9)
- hypoxia
- mucosal trauma
- infection
- bleeding
- atelectasis
- bronchospasm
- cardiac dysrhythmia
- increased ICP in patients with head injury
- bradycardia
48
what are the precautions for ETT suctioning? (8)
- pre-existing upper airway trauma
- bradycardia
- hypoxia
- severe airway obstruction
- facial or basal skull fracture
- hypoxemia
- infection
- blood pressure instability
