Guide line for suctioning technique

Guidelines for Suctioning

Objective

Bismillahirahmanirahim

• To maintain a patent airway by removing mucous secretions and all foreign materials from the oropharynx (mouth and throat) and/or nasopharynx (nose).
• Promote his or her oxygenation and ventilation.
• When there is a presence of a respiratory tract infection or a lung-related disorder, the lungs produce a thick substance known as sputum. This sputum can make it hard to breathe, cause coughing, and harbor bacteria.
• The accumulation of sputum can sometimes be an indication for a doctor to ask for a sputum culture.

Sputum Culture and Sensitivity 

(Sputum C & S)

Alternate Names: Culture and Gram Stain

• This fast, relatively painless test helps laboratory technicians study the bacteria or fungi that might be growing in the lungs and causing the production of the sputum. This can help them find the cause of the illness.
• The most difficult part of a sputum culture is often getting enough material in a sputum sample for testing
• Once the sputum sample is taken for analyzing, it will be then taken to the laboratory to be placed on a special plate that has a nutrient that helps bacteria or other pathogens present in the sputum to grow.
• The laboratory will run a number of tests to determine if the growth is a bacterium, a virus, or a fungus. The laboratory will work to tell the difference between bacteria that makes a person sick and those that helps keep a person well.
• Over the next few days, different antibiotics are added to determine the most effective antibiotic or antifungal to treat the infection.
• A Sputum C & S is also used to diagnose tuberculosis, and determine the most effective treatment for the patient

Getting the specimens 

through suction &Types of Suctioning

• Open Suction

patient disconnected from ventilation device and suctioned with regular suction catheter.

• Closed Suction

utilizes an in-line suction catheter with patient remaining attached to mechanical ventilation. This technique is recommended all for patients, especially those with high oxygen requirements or increased levels of Positive Expiratory End Pressure (PEEP).

NASOPHARYNGEAL  AND
OROPHARYNGEAL
SUCTIONING

• PPE
• Face mask
• Gloves
• Sterile gloves
• Apron E

Apparatus

• Tubing drainage
• Suction catheter
• Saline solution
• Mucus extractor
• Gauze
• Suction Vacuum

Appropriate sized catheter

• Neonates 5 – 8 Fr.
• Pediatrics 8 – 12 Fr.
• Adolescents 12 – 14 Fr.

What to start ?

1. ·         Perform hand hygiene and don PPE.
2. ·         Set up sterile saline for instillation and for flushing of catheter between catheter passes.
3. ·         Open suction catheter package maintaining the sterility of catheter.
4. ·         Attach catheter end to connection tubing from the suction apparatus.  Adjust wall  suction. 
5. ·         Recommended pressures should not exceed 80 – 120 mmHg for pediatrics and 80 -100 mmHg for neonates. Cleanse hands and put on sterile gloves.

Method

1. With sterile gloved hand, advance catheter to pre-measured depth without applying suction.  Utilizing measured depth ensures suction catheter does not extend beyond the pharynx and cause trauma.
2. Apply intermittent suction while slowly withdrawing the catheter, rotating catheter between the finger and thumb.  Continuous suction may be warranted with thick, copious secretions.
3. Duration of intermittent suction should not exceed 10 seconds in paediatric patients or 5 seconds in neonate. 
4. Duration of continuous suction should not exceed 5 seconds in neonate or paediatric patient2.

Wallahuaklam.