Suctioning: Aritificial Airway

Procedure for suctioning an Artificial Airway

1.  Assess patient for risk factors and signs and symptoms of airway obstruction. Also assess for contraindications to nasotracheal suctioning (e.g., facial trauma/surgery, bleeding disorders, nasal bleeding, epiglottitis, croup, laryngospasm, irritable airway).
2.  Assist patient to semi-Fowler’s or similar position, and perform hand hygiene.
3.  Connect tubing to suction machine, turn on device, and set volume regulator.
4.  For one-time use catheter, use aseptic technique to open sterile drape, pour 100 mL normal saline solution or sterile water into basin.
5.  With sterile gloved hands, secure catheter to tubing. Check equipment function by suctioning small amount of normal saline solution from basin.
6.  Hyperoxygenate patient before suctioning.
7.  If patient is receiving mechanical ventilation, open swivel adapter.
8.  Without applying suction, gently but quickly insert catheter into artificial airway until resistance is met or patient coughs; then pull back 1 cm (½ inch).
9.  Apply intermittent suction. Encourage coughing, and watch for respiratory distress.
10. If patient is receiving mechanical ventilation, close swivel adapter.
11. Encourage patient to deep breathe, if able.
12. Rinse catheter and connecting tubing with normal saline. Use continuous suction.
13. Assess patient’s cardiopulmonary status. Repeat steps 1 to 7 once or twice more to clear secretions. Allow at least 1 full minute between suction passes.
14. When pharynx and trachea are sufficiently cleared of secretions, perform oropharyngeal suctioning to clear mouth of secretions. Do not suction nose again.

Completing the Procedure
15. Disconnect catheter from tubing. Pull glove off, turning it inside out over coiled catheter. Pull off other glove over first glove in same way. Turn off suction.
16. Remove towel, reposition patient, and readjust oxygen to original level.
17. Discard all supplies appropriately. Perform hand hygiene.
18. Compare patient’s respiratory assessments before and after suctioning. Observe airway secretions.