Definition
Oropharyngeal suctioning is the process of removing secretions from the oral cavity and pharynx.
Purposes
- To remove secretions those, obstruct the airway.
- To facilitate ventilation.
- To obtain secretions for diagnostic purposes
- To prevent infection that may result from accumulated secretions.
Articles
- Appropriate size sterile suction catheter (smallest diameter that will remove secretions effectively) 12-18 Fr or Yankauer catheter (special catheter for oropharyngeal suctioning)
- Portable or wall suction unit with connecting tubing and Y-connector.
- Sterile water/normal saline in a sterile bowl.
- Clean disposable gloves.
- Face mask
- Nasal or oral airway if indicated.
- Towel or waterproof pad.
Procedure
| Sl.No | Nursing Action | Rationale |
| 1 | Before procedure Assess for signs and symptoms indicating the presence of upper airway secretions. gurgling respirations, restlessness, drooling etc. | Physical signs and symptoms result from decreased oxygen to tissues as well as pooling of secretion in upper airway. |
| 2 | Explain to the client that suctioning will stimulate the cough, gag, or sneeze reflex. | Helps in obtaining cooperation of patient and relieves patients’ anxiety. |
| 3 | Explain the importance of and encourage coughing during the procedure. | Facilitates removal of and frequency and duration of future suctioning |
| 4 | Assemble article | Providing for organized approach |
| 5 | Adjust bed to comfortable working position. Lower side rails closer to you, place the patient in a semi-Fowler’s position if conscious. An unconscious patient should be placed in lateral position facing you. | Having the patient in a string position helps him/her to cough and makes breathing easier. Gravity facilitates the Insertion of the catheter. Lateral position prevents the airway from becoming obstructed and promotes drainage of secretions. |
| 6 | Place towel or waterproof pad across patient’s chest. | Protects bed linen |
| 7 | Wear mask or face shield. | Suction may cause splashing of body fluids. |
| 8 | Wall unit a.Adult: 100-120 mm Hg; Child: 95-110 mmm Hg; Infant: 50-95 mm Hg. b. Portable unit: Adult: 10-15 mm Hg; Child: 5-10 mm Hg; Infant. 2-5 mm Hg | Negative pressure must be at a safe level, otherwise, pneumothorax may occur. |
| 9 | During procedure Wash hands | Reduces transmission of microorganisms |
| 10 | Preform oropharyngeal suctioning. a. Wear clean disposable gloves. b. Connect one end of connecting tubing to suction machine and other to suction catheter, fill sterile bowl with sterile water. c. Suction small amount of sterile water from bowl, d. Remove oxygen mask, if present. e. Insert catheter into mouth along gum line to pharynx. Move catheter in oral cavity until secretions are cleared. Encourage client to cough during suctioning. d. Replaces oxygen mask g. Rinse catheter in a bowl of clean water until connecting tubing is cleared of secretions. Turn off suction. | Prepares suction apparatus. Ensures equipment function and lubricates catheter. Provides continuous suction. Care must be taken not to allow suction tip to invaginate oral mucosal surfaces. Rinses catheter and reduces probability of transmission of microorganisms |
| 11 | Reassess client’s respiratory status. | |
| 12 | Remove towel, place in laundry bag. Remove gloves and dispose in appropriate receptacle. | Reduces transmission of microorganisms. |
| 13 | Reposition client: Simi’s position encourages drainage and should be used if client has decreased level of consciousness. | Facilitates drainage of oral secretions |
| 14 | After procedure Wash and since used articles with warm soapy water and dry with paper towels. | Reduces transmission of organisms to other clients. |
| 15 | Place catheter in clean dry area. | |
| 16 | Wash hand | |
| 17 | Document the procedure in nurse’s record. | Provides for communication between staff members. |
Special Considerations
- For patients who have undergone oropharyngeal surgery, the procedure has to be performed using strict aseptic technique.
- A suction attempt should last only 10-15 seconds.
- Allow 20-50 seconds intervals between each section and limit suction to 5 minutes in total.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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