Week 9- Suction and Tracheostomy Management Flashcards
(24 cards)
What is suctioning used for?
Clear the airway of: vomit, saliva, blood, food, foreign objects
When can you suction during a call?
ANYTIME
Goal of suction=
to CLEAR the airway
All EMS ambulances must have: (3)
a portable suction device
hand held device
wall unit in ambulance
Lateral Compact Suction unit:
(holds how much? battery life?)
holds 300mLs
45 min battery life
light weight
S Cort Suction unit
(suction rate?)
light weight
500mmHg for adults
125mmHg for children
disposible canister
Different suction catheters:
Widebore- used in mouth
Yankeur- used in mouth
In line/closed suction- nose, trach, down ETT
Oral SUCTION PRESSURES
adult= 500- 550 mmHg
children= 200-220 mmHg
infant= 80-100mmHg
Deep SUCTION PRESSURES
adult= 100-150mmHg
children= 100-120mmHg
infant= 60-100mmHg
How do you suction the oropharynx?
open pt’s airway and insert suction tip/catheter
NEVER go passed the base of the tongue (could trigger gag reflex)
suction for 5-10 sec on the way OUT!
Oropharynx suctioning procedure:
roll or sit up pt withe larger amounts of secretions
set correct pressure for the pt
put the catheter or large bore in mouth
occlude the hole to initate the suction
suction of the way out for 5-10 secs
pt requires oxygenation between attempts for 1 min
Tracheostomy suctioning procedure:
set correct pressure for the pt
put the catheter in until you feel resistance
occlude the hole to initiate the suction
suction of the way out for 5-10 secs, oxygenate in between for 1 min
have saline to clean catheter
Inline closed suction is only for:
ETT (intubation) and TRACHEOSTOMY
- most used
- less germs spread
- able to use with BVM
procedure is same as trach suction
REMEMBER: Only suction as far as you can_____
SEE !!!!
Parts of a tracheostomy: (4)
Inner cannula
Neck plate (all the info is here)
Ties or straps
Obtorator
Indications of a trach reinsertion:
- pt w existing tracheostomy tube where the inner and outer cannula have been removed from the airway
- resp distress AND
- inability to adequately ventilate AND
- there is no family or caregiver who is available and knowledge to replace trach cannula
Steps to reinsert –>
- ASK family member, encourage them to do it!!
- Attempt twice MAX
Ensure SPO2 is applied, check if pt breaths via the mouth or JUST trachea - Ventilate them
- If via the mouth: dressing to the stoma
-If by the trach: place the o2 mask or BVM directly over the tracheostomy
What is a laryngectomy?
removoval of the larynx= no connection between mouth and trachea
What is the most common trach problem?
Obstructed by mucous! Suction first!!
What is ETCO2?
End tidal Carbon Dioxide
- the level of CO2 that is released at the END of an exhaled breath
- reflects the adequacy of CO2 that is being carried back into the lungs and exhaled
What is a normal ETCO2 value?
35-45mmHg
What is ETCO2 an indication of?
VENTILATION
What does Increased resp rate: hyperventilation in terms of ETCO2…
blowing off CO2= decreased ETCO2 value
What does decreased resp rate: hypoventilation in terms of ETCO2…
retaining CO2= increased ETCO2 value
