Suctioning-the-Nasopharyngeal-Airway

Introduction

  • Topic: Suctioning the Nasopharyngeal Airway

  • Author: John Nichol B. Angeles, RN, MAN

  • Institution: LPU-College of Nursing

Purpose

  • Main Objective:

    • To remove secretions from the pharynx using a suction catheter inserted through the nostril.

Assessment

  • Facility's Policy:

    • Check if a physician's order is needed for oropharyngeal suctioning.

  • Client's Vital Signs:

    • Evaluate blood gas or oxygen saturation values.

  • Coughing Ability:

    • Assess client's ability to cough and deep breathe to determine effectiveness in moving secretions.

  • Health History:

    • Look for any history of nasal issues such as deviated septum, nasal polyps, nasal obstruction, traumatic injury, epistaxis, or mucosal swelling.

Equipment Needed

  • Suction Equipment:

    • Wall or portable suction unit

    • Connecting tubing

    • Sterile normal saline solution

    • Disposable sterile container

    • Sterile suction catheter (#10 to #16 French for an adult)

    • Sterile gloves

    • Clean gloves

    • Goggles

    • Optional: nasopharyngeal or oropharyngeal airway for frequent suctioning

    • Over bed table

    • Waterproof trash bag

    • Towel

Procedure Steps

Pre-Procedure Setup

  1. Patient Identification:

    • Use two client identifiers for safety.

  2. Explain Procedure:

    • Inform the client about suctioning; reassure even if they are unresponsive.

    • Explain that suctioning may cause coughing or gagging, which helps mobilize secretions.

  3. Hand Hygiene:

    • Wash hands before beginning the procedure.

  4. Equipment Arrangement:

    • Position suction equipment on the bedside and connect tubing.

    • Open and prepare normal saline, trash bag, and necessary supplies.

  5. Personal Protective Equipment (PPE):

    • Wear appropriate PPE.

Suctioning Technique

  1. Set Suction Pressure:

    • Turn on suction unit and adjust to 100-150 mm Hg according to policy.

    • Test suction pressure by occluding the tubing.

  2. Client Positioning:

    • Position client in semi-Fowler's or high-Fowler's if tolerated.

    • For unconscious clients, position them on their side to promote drainage.

  3. Preparation for Catheter Insertion:

    • Place a towel across the client's chest.

    • Open the suction catheter kit using aseptic technique.

    • Pour saline solution into a sterile container.

  4. Catheter Handling:

    • With the dominant hand, pick up the catheter and connect it to tubing.

    • Control suction valve with non-dominant hand while inserting.

  5. Insertion Protocol:

    • Lubricate the catheter tip (3-4 inches).

    • Instruct the client to cough and breathe deeply to loosen secretions.

    • Gently insert catheter into the nostril 5-6 inches until reaching secretions or coughing.

  6. Suctioning Execution:

    • Withdraw catheter intermittently with a rotating motion while applying suction (10-15 seconds).

    • Wrap catheter around dominant hand between passes to prevent contamination and clear the lumen.

    • Repeat up to 3 times or until normal breath sounds resume.

Post-Procedure Care

  1. Cleaning Up:

    • Flush connecting tubing with saline; discard used items.

    • Replace with new supplies for future use.

  2. Personal Hygiene:

    • Remove PPE and wash hands.

  3. Client Care:

    • Allow the client to rest post-suctioning; monitor closely.

  4. Documentation:

    • Record suctioning details: date, time, reason, technique, secretions characteristics, respiratory status changes, and any complications.

Conclusion

  • Thank you message:

    • "SALAMAT!" indicating gratitude and completion.