This document provides a procedure checklist for oropharyngeal and nasopharyngeal suctioning. It outlines 27 steps to perform the procedures, including assessing the patient, preparing equipment, positioning the patient, inserting the suction catheter, applying suction, and evaluating the patient after completion. Performance is rated on a scale of 5 to 0 based on how systematically and independently the student carries out the procedures and observes personality traits. The total score is calculated and must be above 65 to pass.
This document provides a procedure checklist for oropharyngeal and nasopharyngeal suctioning. It outlines 27 steps to perform the procedures, including assessing the patient, preparing equipment, positioning the patient, inserting the suction catheter, applying suction, and evaluating the patient after completion. Performance is rated on a scale of 5 to 0 based on how systematically and independently the student carries out the procedures and observes personality traits. The total score is calculated and must be above 65 to pass.
This document provides a procedure checklist for oropharyngeal and nasopharyngeal suctioning. It outlines 27 steps to perform the procedures, including assessing the patient, preparing equipment, positioning the patient, inserting the suction catheter, applying suction, and evaluating the patient after completion. Performance is rated on a scale of 5 to 0 based on how systematically and independently the student carries out the procedures and observes personality traits. The total score is calculated and must be above 65 to pass.
This document provides a procedure checklist for oropharyngeal and nasopharyngeal suctioning. It outlines 27 steps to perform the procedures, including assessing the patient, preparing equipment, positioning the patient, inserting the suction catheter, applying suction, and evaluating the patient after completion. Performance is rated on a scale of 5 to 0 based on how systematically and independently the student carries out the procedures and observes personality traits. The total score is calculated and must be above 65 to pass.
Rate the student's performance by checking the appropriate box using the following criteria: 5 - Excellent (Carries out procedures efficiently, systematically and independently/Personality trait is observed at all times) 4 - Very Satisfactory (Carries out procedures efficiently and systematically but requires minimal guidance and supervision/Personality trait is observed at all times) 3 - Satisfactory (Carries out the procedures efficiently and systematically but requires moderate guidance and supervision/Personality trait is observed at all times) 2 - Fair (Carries out the procedures efficiently and systematically but requires close guidance and supervision/Personality trait is observed at all times) 1 - Poor (Carries out the procedures inefficiently, unsystematically even under close guidance and supervision/Personality trait is observed at all times) 0 - Not done
Criteria 5 4 3 2 1 0 ASSESSMENT 1. Assess signs and symptoms of upper and lower airway obstruction including wheezes, crackles, or gurgling on inspiration or expiration, restlessness, ineffective coughing, absent or diminished breath sounds, tachypnea, cyanosis, decreased level of consciousness. 2. Assess for signs of respiratory distress PLANNING 1. Prepares necessary equipment and supplies. Suction catheter which is appropriate size for client: Infants: 5-8 Fr Children: 8-10 Fr Adults: 12-18 Fr Suction Apparatus: Wall Unit: Neonates: 60-80 mmHg Infant: 80-125 mmHg Children: 80-125 mmHg Adolescent: 80-150 mmHg Adults: 100-150 mmHg Sterile disposable gloves, mask, googles, face shield Sterile water or normal saline approximately 100 mL in a glass container or basin Connecting tubes (6 feet) and collecting bottle Clean towel/ Water proof pad If not using closed-suction catheter Water-soluble lubricant Small Y adapter if catheter does not have a suction port Sterile basin Sterile normal saline solution Collection Receptacle
Oropharyngeal and Nasopharyngeal Suctioning
Rev. 11.00.2018 Page 1 of 4 Criteria 5 4 3 2 1 0 IMPLEMENTATION 1. Wash hand thoroughly. 2. Identify the person, and greet him or her by name. 3. Explain to patient how procedure will help clear airway and relieve breathing problems. Explain that coughing, sneezing or gagging is normal for oral suctioning. 4. Provide privacy by showing any visitor where they should wait, if necessary, until you have completed the procedure. Close the door and the curtain. 5. Position the client: 5.1 Conscious Client: Semi fowler’s position with the head turned to one side for oral suctioning and neck hyperextended for nasal suctioning 5.2 Unconscious Client: lateral position facing the nurse 6. Place the towel or moisture resistant pad over the pillow or under the chin 7. Prepare the Suction Apparatus 7.1 Connect one end of connecting tubing to suction machine and place other end in convenient location near patient 7.2 Turn suction device on and set vacuum regulator to appropriate negative pressure 8. Washes hands and opens suction catheter package Do not allow suction catheter to touch any surface other than inside of it's package. 9. Fills container with 100ml sterile NSS/ water 10. Wear mask. 11. Apply sterile gloves to each hand and designate the sterile which is the dominant hand and non-sterile which is the non-dominant hand. 12. Pick up suction catheter with dominant hand without touching non-sterile surfaces. Pick up connecting tubing with non-dominant hand then connect suction catheter to the connecting tube. 13. Check the equipment if functioning properly by suctioning small amount of saline from the basin. 14. Oropharyngeal Suctioning 14.1 Remove oxygen mask if present. Keep oxygen mask near the patient’s face. If patient has a nasal cannula, it may remain in place. 14.2 Moisten the Yankauer Catheter/ Suction tip with saline water or water soluble lubricant 14.3 Advance the catheter about 10 to 15 cm (4 to 6 in.) along one side of the mouth into the oropharynx. 14.4 It may be necessary during oropharyngeal suctioning to apply suction to secretions that collect in the mouth and beneath the tongue. 14.5 With suction applied intermittently, move catheter around mouth, including pharynx and gum line, until secretions are cleared.
Oropharyngeal and Nasopharyngeal Suctioning
Rev. 11.00.2018 Page 2 of 4 Criteria 5 4 3 2 1 0 14.6 Replace the oxygen delivery device using your nondominant hand, if appropriate, and have the patient take several breaths 14.7 Flush catheter with saline. Assess effectiveness of suctioning and repeat, as needed, and according to patient’s tolerance. Wrap the suction catheter around your dominant hand between attempts. 15. Nasopharyngeal Suctioning 15.1 Lightly coat distal 6-8 cm (2-3 inches) of catheter tip with water-soluble lubricant. 15.2 Remove oxygen-delivery device, if applicable, with nondominant hand. Without applying suction and using dominant thumb and forefinger, gently insert catheter into naris during inhalation. 15.3 Have the patient take a deep breath and insert catheter, following natural course of naris; slightly slant catheter downward and advance to the back of pharynx. Do not force through naris. In adults insert catheter about 16 cm (6 inches); in older children, 8 to 12 cm (3 to 5 inches); in infants and young children. 4 to 8 cm (2 to 3 inches). Rule of thumb is to insert catheter distance from tip of nose (or mouth) to angle of mandible. 16. Once correct position is ascertained, apply suction for 5-10 sec. gently rotates the catheter while pulling it slighlt upward. 17. Apply intermitent suction by placing and releasing non- dominant hand thumb over vent of catheter and slowly withdraw catheter in twisting motion. Encourage patient to cough. 18. Replace oxygen delivery device. Encourage patient to deep breath. 19. Rinse catheter and connecting tubing with normal saline until clear. Use continuous suction. 20. Repeat steps 13 or 14 as needed to clear secretions. Allow adequate time (at least 1 full minute) between suction passes for ventilation and re-oxygenation. 21. Assess patient's cardiopulmonary status between suction passes. 22. When pharynx and trachea are sufficienlty cleared of secretions. Perform oropharyngeal suctioning to clear mouth of secretions. 23. Remove towel and place in laundry or appropriate receptacle. 24. Coil suction catheter in the dominant hand. Disconnect suction catheter from connecting tubing. Remove sterile gloves with the used suction catheter inside to prevent contamination and discard in appropriate waste receptacle. 25. Reposition patient. 26. Discard remainder of the normal saline into appropriate receptacle. If basin is reusable, place it in soiled utility room.
Oropharyngeal and Nasopharyngeal Suctioning
Rev. 11.00.2018 Page 3 of 4 Criteria 5 4 3 2 1 0 27. Wash hands and place unopened suction kit on suction machine or at head of bed. EVALUATION 1. Auscultates the clients breath sounds to ensure they are clear of secretions, observes skin color, dyspnea 2. Measure heart rate, BP, RR, and Oxygen Saturation 3. Records the patient’s tolerance of procedure, amount, consistency, color and odor of sputum of secretions removed and complications 4. Reports ant patient’s intolerance of procedure (Changes of vital signs, bleeding, laryngospasm, upper airway noise.)
Total Score:
Comments/Suggestions:
Computation: Total Score divided by (number of items) x 20 (factor) = _________________
*Total points shall be transmuted using the table for 100 pts. Passing cut-off point is 65.
