a nurse is reviewing protocol in preparation for suctioning secretions

Charlotte

3 min read

·

26-02-2025

1

0

Share

Meta Description: Learn the essential steps and precautions for safe and effective suctioning of respiratory secretions. This comprehensive guide covers indications, contraindications, equipment preparation, and post-procedure care, ensuring nurses are well-prepared for this critical procedure. This detailed protocol review will enhance your skills and patient safety.

Suctioning is a crucial nursing procedure used to remove secretions from the airways of patients who are unable to clear them independently. This article provides a thorough review of the protocol for nurses preparing to perform this procedure. Accurate and timely suctioning is vital for maintaining airway patency and preventing respiratory complications.

Indications for Suctioning

Before initiating suctioning, a nurse must carefully assess the patient's need. Suctioning is indicated when a patient exhibits signs of airway obstruction, such as:

• Increased respiratory rate or difficulty breathing (dyspnea): Noticeable labored breathing or shortness of breath.
• Audible wheezing or gurgling: Sounds indicating the presence of excessive secretions in the airways.
• Decreased oxygen saturation (SpO2): Lower than the established baseline or below 90% (unless otherwise specified by medical orders).
• Restlessness, anxiety, or changes in mental status: These can be subtle signs of hypoxia related to airway obstruction.
• Increased work of breathing: Visible use of accessory muscles, retractions, or nasal flaring.

Important Note: Always refer to the physician's orders and the patient's specific care plan before initiating suctioning.

Contraindications and Precautions

While essential, suctioning carries some risks. Certain conditions may contraindicate or require extra caution:

• Recent laryngeal or tracheal surgery: Suctioning could damage delicate surgical sites.
• Bleeding disorders: Increased risk of bleeding from the airway.
• Suspected head injury: Suctioning could increase intracranial pressure.
• Facial trauma: Potential for further damage.

Equipment Preparation: A Step-by-Step Guide

Accurate preparation prevents complications and ensures patient safety. Here's the essential equipment needed:

1. Suction Catheter: Select the appropriate size (French gauge) based on patient anatomy and the physician's order. Smaller catheters are generally preferred to minimize trauma.
2. Suction Machine: Ensure it's functioning correctly and set to the appropriate pressure (80-120 mmHg for adults, lower for children).
3. Sterile Gloves: Maintain a sterile field to prevent infection.
4. Sterile Saline Solution: Use for catheter lubrication and to help dislodge secretions.
5. Oxygen Source: Have supplemental oxygen readily available to counteract any potential hypoxia during and after the procedure.
6. Protective Eyewear and Gown (if applicable): Protect yourself from potential splashes.
7. Suction Tubing and Collection Container: Ensure proper connections and a functioning collection system.

Suctioning Technique: A Detailed Protocol

Follow these steps meticulously for effective and safe suctioning:

1. Assess the Patient: Re-evaluate the patient's respiratory status before beginning. Note the respiratory rate, oxygen saturation, and any other pertinent observations.
2. Hand Hygiene: Thoroughly wash your hands with soap and water or use an alcohol-based hand sanitizer.
3. Don Sterile Gloves: Maintain a sterile technique throughout the procedure.
4. Lubricate the Catheter: Generously lubricate the catheter with sterile saline solution to minimize trauma to the airway.
5. Insert the Catheter: Gently insert the catheter into the airway, avoiding forceful insertion. Advance the catheter only as far as necessary to reach the secretions.
6. Apply Suction: Apply intermittent suction while slowly withdrawing the catheter, rotating gently to maximize secretion removal. Avoid prolonged suctioning, as this can cause hypoxia and tissue damage. Limit suction to no more than 10-15 seconds per pass.
7. Repeat as Necessary: Repeat steps 5 and 6 until secretions are cleared.
8. Monitor the Patient: Closely monitor the patient's vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation) and respiratory status after each suction pass.
9. Document the Procedure: Thoroughly document the procedure in the patient's medical record, noting the time, amount and characteristics of secretions removed, and the patient's response.

Post-Suctioning Care

After the procedure, provide the patient with rest and monitor closely for any adverse effects. This includes:

• Oxygen Supplementation: Administer supplemental oxygen if needed to maintain adequate oxygen saturation.
• Assessment: Continue assessing respiratory status, including auscultation of lung sounds.
• Hydration: Encourage adequate fluid intake to help thin secretions.
• Deep Breathing Exercises: Assist the patient with deep breathing and coughing exercises to help clear any remaining secretions.

Potential Complications

While rare with proper technique, complications can occur:

• Hypoxemia (low blood oxygen): Due to prolonged suctioning or inadequate oxygenation.
• Infection: From contaminated equipment or technique.
• Trauma to the airway: From forceful insertion or excessive suction.
• Cardiac arrhythmias: Stimulation of the vagus nerve.
• Bleeding: From irritation or damage to the airway mucosa.

Regularly reviewing suctioning protocols ensures nurses maintain competence and patient safety. Adherence to a standardized procedure minimizes risks and enhances the effectiveness of this essential nursing intervention. Always refer to your institution’s specific guidelines and policies.