Nursing Care Related to the
Cardiovascular and Respiratory Systems 2-20 |
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2-20. ENDOTRACHEAL SUCTIONING
a. The procedures for endotracheal (within the trachea) suctioning are similar to those used for naso and oropharyngeal suctioning with two major differences.
b. Wash your hands, then assemble and set up the suction equipment.
c. Using aseptic technique, open the catheter package just enough to expose the connecting end and connect the catheter to the suction tubing. Don the sterile gloves. Using aseptic technique, remove the catheter from the package and hold it in your dominant hand. Test the catheter by aspirating some of the sterile solution.
d. Pick up a piece of the gauze with your non-dominant hand and grasp the patient's tongue. Gently pull the tongue out of the mouth. This will provide a view of the oropharynx and at the same time raise the epiglottis to permit easier insertion of the catheter into the trachea. As an alternative method, the catheter may be introduced through the nose.
e. As the patient inhales, introduce the catheter (with suction diverted) toward the posterior of the mouth and down the throat into the trachea. The patient will probably cough at this point. If coughing brings up sufficient secretions to clear the air passages, the procedure may be discontinued at this point. If not, relax the tongue a bit and instruct the patient to breathe normally.
f. Apply suction and gently rotate the catheter to aspirate secretions. Remember to suction for only 5-10 seconds at a time. Withdraw the catheter and rinse between suctioning by aspirating sterile solution. This will keep the catheter moist and free of secretions that may block the lumen.
g. Repeat the procedure until the secretions have been cleared. Remember that frequent catheter introductions irritate the tracheal mucosa, so suction thoroughly to avoid repeated insertions.
h. Observe the patient closely for changes in color or respiration, disorientation, or agitation. These could be signs of anoxia. Listen to the patient's breath sounds, which should become quieter as secretions are removed. |
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