CH I-A: suctioning [retdem]

95%+ rd pls

Gather 12 supplies

1st procedure of suctioning includes:

1. Yankauer or suction catheter

2. Suction machine or wall suction device

3. Suction canister connecting tubing

4. Pulse oximeter

5. Stethoscope

6. Face mask

7. Goggles or face shield

8. Nonsterile gloves

9. Sterile gloves [for suctioning with sterile suction catheter]

10. Towel or disposable paper drape

11. Nonsterile basin or disposable cup

12. Normal saline or tap water

Gather 12 supplies which are:

Perform hand hygiene

2nd procedure of suctioning includes:

Check the room for transmission-based precautions

3rd procedure of suctioning includes:

Introduce 4 things:

1. Yourself

2. Your role

3. Purpose of visit

4. Estimated time for procedure

4th procedure of suctioning includes:

Confirm patient ID using 2 patient identifiers [name and date of birth]

5th procedure of suctioning includes:

Explain process to patient

6th procedure of suctioning includes:

Ensure patient’s privacy and dignity

7th procedure of suctioning includes:

Assess ABCs

8th procedure of suctioning includes:

Adjust bed to comfortable working height

9th procedure of suctioning includes:

Lower side rail closest to you

10th procedure of suctioning includes:

Place px in Semi-Fowler’s position & facing you if patient is conscious

11th procedure of suctioning includes:

Place px in lateral position & facing you if patient is unconscious

12th procedure of suctioning includes:

Move bedside table close to work area

13th procedure of suctioning includes:

Raise table to waist height

14th procedure of suctioning includes:

Place towel/waterproof pad across patient’s chest

15th procedure of suctioning includes:

Adjust wall suction device to 4 appropriate pressures

16th procedure of suctioning includes:

1. Adults and adolescents: no more than 150 mm Hg

2. Children: no more than 120 mmHg

3. Infants: no more than 100 mm Hg

4. Neonates: no more than 80 mm Hg

Wall suction device has 4 appropriate pressures & include:

Adjust portable suction device to 4 appropriate pressures

17th procedure of suctioning includes:

1. Adults: 10 to 15 cm Hg

2. Adolescents: 8 to 15 cm Hg

3. Children, infants: 8 to 10 cm Hg

4. Neonates: 6 to 8 cm Hg

Portable suction device has 4 appropriate pressures & include:

Put on clean glove

18th procedure of suctioning includes:

Occlude end of connection tubing [to check suction pressure]

19th procedure of suctioning includes:

Open sterile suction catheter using aseptic technique

20th procedure of suctioning includes:

Carefully remove sterile container, touching only outside surface

21st procedure of suctioning includes:

Set it up on the work surface [open wrapper/container becomes sterile field to hold other supplies]

22nd procedure of suctioning includes:

Fill kidney basin with sterile saline using sterile technique

23rd procedure of suctioning includes:

Fill kidney basin with sterile saline using sterile technique

24th procedure of suctioning includes:

Place small amount of water-soluble lubricant on sterile field

25th procedure of suctioning includes:

Take care to avoid touching sterile field with lubricant package

26th procedure of suctioning includes:

Increase/apply the patient’s supplemental oxygen level per facility policy or primary care provider order

27th procedure of suctioning includes:

Don additional PPE

28th procedure of suctioning includes:

Put on face shield or goggles and mask

29th procedure of suctioning includes:

Don sterile gloves

30th procedure of suctioning includes:

Manipulate the catheter via dominant hand and it must remain sterile

31st procedure of suctioning includes:

Moisten catheter by dipping it into container of sterile saline

32nd procedure of suctioning includes:

Occlude the suction valve on the catheter [to check for suction]

33rd procedure of suctioning includes:

Encourage patient to take several deep breaths

34th procedure of suctioning includes:

Apply lubricant to first 2-3 inches of catheter using lubricant that was placed on sterile field

35th procedure of suctioning includes:

Remove oxygen delivery device, if appropriate

36th procedure of suctioning includes:

Do not apply suction as catheter is inserted

37th procedure of suctioning includes:

Hold catheter between thumb and forefinger

38th procedure of suctioning includes:

For nasopharyngeal suctioning, gently insert catheter through naris and along floor of nostril toward trachea

39th procedure of suctioning includes:

Roll catheter between fingers to help advance it

40th procedure of suctioning includes:

Advance catheter approximately 5-6 inches to reach pharynx

41st procedure of suctioning includes:

For oropharyngeal suctioning, insert the catheter through mouth, along side of mouth toward trachea

42nd procedure of suctioning includes:

Advance catheter 3-4 inches to reach pharynx

43rd procedure of suctioning includes:

Apply suction by:

1. Intermittently occluding suction valve on catheter with thumb of nondominant hand

2. Continuously rotate catheter as it is being withdrawn

44th procedure of suctioning includes:

Suction only on withdrawal [do not suction for more than 10-15 seconds at a time to minimize tissue trauma]

45th procedure of suctioning includes:

Replace oxygen delivery device using nondominant hand, if appropriate

46th procedure of suctioning includes:

Have patient take several deep breaths

47th procedure of suctioning includes:

Flush catheter with saline

48th procedure of suctioning includes:

Assess effectiveness of suctioning by listening to lung sounds and repeat, as needed, and according to patient’s tolerance

49th procedure of suctioning includes:

Wrap suction catheter around dominant hand between attempts

50th procedure of suctioning includes:

Repeat procedure up to 3 times until:

1. gurgling/bubbling sounds stop, and

2. respirations are quiet

51st procedure of suctioning includes:

Allow 30-60 seconds between passes to allow reoxygenation and reventilation

52nd procedure of suctioning includes:

Remove gloves from dominant hand over coiled catheter & pull them off inside out

53rd procedure of suctioning includes:

Remove glove from nondominant hand

54th procedure of suctioning includes:

Dispose of 3 things in appropriate receptacle

1. Gloves

2. Catheter

3. Container with solution

55th procedure of suctioning includes:

Assist patient to comfortable position

56th procedure of suctioning includes:

Raise the bed rail

57th procedure of suctioning includes:

Place bed in lowest position

58th procedure of suctioning includes:

Turn off suction

59th procedure of suctioning includes:

Remove supplemental oxygen placed for suctioning, if appropriate.

60th procedure of suctioning includes:

Remove face shield & face mask

61st procedure of suctioning includes:

Perform hand hygiene

62nd procedure of suctioning includes:

Perform oral hygiene on patient after suctioning

63rd procedure of suctioning includes:

Reassess patient in 5 aspects

64th procedure of suctioning includes:

1. Respiratory status

2. Respiratory rate

3. Respiratory effort

4. Oxygen saturation

5. Lung sounds

Reassess patient in 5 aspects which include:

Assist patient to comfortable position

65th procedure of suctioning includes:

Ask if they have any questions

66th procedure of suctioning includes:

Thank them for their time

67th procedure of suctioning includes:

Perform hand hygiene

68th procedure of suctioning includes:

Document procedure and related assessment findings

69th procedure of suctioning includes:

Report any concerns according to agency policy

70th procedure of suctioning includes: