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Bulb Syringe

  Observe for the signs and symptoms that indicate need for oral or nasal suctioning.

  1. Assess vital signs, including SpO2 if monitoring.
  2. Assess for contraindications to the bulb syringe use such as oropharyngeal and nasal malformations.
  3. Place clean linen or trash receptacle at bedside.
  4. Position the infant side-lying or supine with head turned to the side.
  5. Explain the procedure to the family.
  6. Perform hand hygiene and apply clean gloves.
  7. Verify the patient's identity using two patient identifiers in accordance with institutional policy.
  8. Grasp the bulb syringe in one hand and depress the bulb to desired depth.
  9. Insert the bulb syringe tip into one side of oral cavity, pointing toward the secretions.
  10. Release the bulb in a controlled manner while gradually removing the bulb tip from the mouth.
  11. After completely removing the bulb syringe tip from the mouth, aim the tip close to the trash receptacle or clean linen and squeeze the bulb several times to empty the secretions from bulb. If necessary, rinse the bulb syringe by pulling clean or sterile water up into the bulb using depress/release technique, and squeezing the water out over a sink or basin. Wipe tip of the bulb syringe with clean linen as needed. Maintain the clean technique.
  12. Observe respiratory status and repeat the procedure as necessary to remove excess oral secretions, while assessing procedure tolerance. Use blow-by oxygen (O2) during procedure if indicated, and continue or stop intervention depending on the infant's status.
  13. Repeat the procedure with each nare as needed. Lubricate the tip and/or nares as needed with sterile saline. Insert the tip into the nare only as far as necessary to obtain an appropriate seal around tip of the syringe. DO NOT FORCE.
  14. Remove the syringe tip slowly while gradually releasing the bulb. Empty and clean the bulb as done before.
  15. Place the bulb in a clean, dry area close to the infant's head.
  16. Remove gloves and discard in proper trash receptacle. Perform hand hygiene.
  17. Document the procedure in the patient's record.