Chapter 28
Respiratory Care
583
Skill 28.6 (continued)
12. Lubricate the first 3 to 4 inches of the suction catheter with the water-soluble lubricant.
3. Remove the glove from your nondominant hand and wash or sanitize your hands to prevent cross-contamination. 4. Put on clean gloves because oral suctioning is not a sterile procedure. 5. Attach the Yankauer, or tonsil-tip, suction device to the suction tubing. 6. Insert the tonsil tip into the patient’s mouth to the back of the throat and then cover the opening with your thumb or fi nger to create suction.
13. Insert the sterile catheter into the right nostril. Safety: Do not apply your thumb while entering the nose and throat to prevent causing hypoxia. 14. Continue inserting the catheter through the nose to the back of the throat. 15. Apply your thumb to the valve as you gently but quickly pull the catheter out of the throat and nose. Safety: Use intermit- tent suction by lifting your thumb periodically. Suction for no longer than 10 to 15 seconds at a time to prevent hypoxia.
7. Suction each side of the throat, in the cheek pouches, and around the tongue to remove mucus. 8. Insert the tonsil tip into the saline in the basin or cup and place your thumb or finger over the valve to rinse the inside and outside of the tonsil tip. Repeat as necessary during suctioning of the mouth. 9. Disconnect the rinsed tonsil tip and replace it in the wrapper for reuse. Follow your facility’s policy for the length of time it can be used. 10. Follow the Ending Implementation Steps located on the inside back cover. Evaluation Steps 1. Auscultate the patient’s lungs and listen to the patient breathe to determine that the airways are clearer after suctioning. 2. Evaluate the patient’s response to the procedure. Did they complain of shortness of breath? Pain or discomfort? Fatigue?
16. Insert the catheter into the basin or cup of saline and apply your thumb to the valve to rinse the inside and outside of the catheter. 17. Repeat Steps 11 through 14 going through the left nostril. 18. The suction catheter can now be used to suction the patient’s mouth, which has a higher number of bacteria and pathogens present, so it is suctioned last. However, some patients may find this objectionable. Also, the patient may bite down on the suction catheter if it is inserted into the mouth. It is appropriate to change to a Yankauer, or ton- sil-tip, suction device at this time. For Oropharyngeal Suctioning 2. Disconnect the suction catheter from the suction tubing. Hold the catheter in the palm of your dominant hand and remove the glove over the catheter. This contains the cathe- ter for disposal and prevents contamination of the hands.
Sample Documentation
10/11/28 1730 Respirations moist sounding, with rattling in throat. Coarse crackles heard in bilateral upper lobes. _________________________________________________ Nurse’s signature and credentials
10/11/28 1745 Nasopharyngeal suctioning performed. Lrg amt of thick white mucus obtained. Suctioned orally for sm amt of yellow mucus. Lung sounds clear bilaterally. Resp quiet and even at 20/min. ____________________________________________________________________ ________________________________________________ Nurse’s signature and credentials
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