After oropharyngeal suctioning, what does the nurse do with the supplies?

Suctioning can be scary and uncomfortable. Prepare the patient ahead of time by telling them what you need to do and why—even if they seem uncooperative. When working with a child or a person with cognitive disabilities, explain things in terms they can understand, and be warm and reassuring. Ask their caregiver to remain present and avoid using force or restraints unless absolutely necessary.

During the procedure, reassure the patient that they are safe. If there are unusual sounds that could be frightening or complications that require additional treatment, continue to reassure the patient and talk them through what you are doing. Even if the patient is very young, very old, or very confused, talking to them can be reassuring and is a sign of respect. Do not talk about the patient as if they are not there or cannot hear you.

Do Not Suction Too Long 

Prolonged suctioning increases the risk of hypoxia and other complications. Never suction a patient for longer than 15 seconds. Rather than prolonged suctioning, withdraw the catheter, re-oxygenate the patient, and suction again.

Avoid Forcing the Catheter 

A difficult airway can be stressful and upsetting, particularly if the patient requires emergency suctioning. Yet forcing the catheter can cause serious airway trauma. Never force the catheter, and do not attempt to insert it into an airway you cannot see. 

Monitor for Complications 

During and after suctioning, monitor the patient for common complications such as bradycardia and hypoxia. Take their vital signs before and after the procedure and be mindful of any complaints the patient reports. Light-headedness, difficulty breathing, a racing heart, raspy breathing sounds, and similar symptoms may signal suction-related complications. 

Choose the Right Equipment 

Without the right equipment, even a flawless suctioning technique may prove inadequate. The right catheter size is key. In most cases, the suction catheter should have an external diameter that is less than half the internal diameter of the endotracheal tube. Geriatric and pediatric populations often require smaller suction catheters. Children have smaller airways, and elders may have more difficult airways due to loss of muscle tone. 

You must also choose the right catheter for the job. For patients who are continuously vomiting or bleeding during resuscitation, the DuCanto catheter enables rapid airway decontamination via the SALAD technique.

A portable emergency suction machine offers more than just emergency care. It enables nurses to care for patients wherever and whenever they need treatment, including while being transported to surgical wings. A portable machine also ensures you can meet your obligations under the Emergency Medical Treatment and Labor Act (EMTALA) to provide treatment to patients within a 250-yard radius of the hospital. For help choosing the right suction machine for your patients, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.

Editor's Note: This blog was originally published in April 2021. It has been re-published with additional up to date content.

The upper airway warms, cleans and moistens the air we breathe. The trach tube bypasses these mechanisms, so that the air moving through the tube is cooler, dryer and not as clean.  In response to these changes, the body produces more mucus.  Suctioning clears mucus from the tracheostomy tube and is essential for proper breathing. Also, secretions left in the tube could become contaminated and a chest infection could develop.  Avoid suctioning too frequently as this could lead to more secretion buildup.

Removing mucus from trach tube without suctioning

1. Bend forward and cough. Catch the mucus from the tube, not from the nose and mouth.
2. Squirt sterile normal saline solutions (approximately 5cc) into the trach tube to help clear the mucus and cough again.
3. Remove the inner tube (cannula).
4. Suction.
5. Call 911 if breathing is still not normal after doing all of the above steps.
6. Remove the entire trach tube and try to place the spare tube.
7. Continue trying to cough, instill saline, and suction until breathing is normal or help arrives.

When to suction

Suctioning is important to prevent a mucus plug from blocking the tube and stopping the patient's breathing.  Suctioning should be considered

• Any time the patient feels or hears mucus rattling in the tube or airway
• In the morning when the patient first wakes up
• When there is an increased respiratory rate (working hard to breathe)
• Before meals
• Before going outdoors
• Before going to sleep

The secretions should be white or clear. If they start to change color, (e.g. yellow, brown or green) this may be a sign of infection. If the changed color persists for more than three days or if it is difficult to keep the tracheostomy tube intact, call your surgeon's office. If there is blood in the secretions (it may look more pink than red), you should initially increase humidity and suction more gently. A Swedish or artificial nose (HME), which is a cap that can be attached to the tracheostomy tube, may help to maintain humidity. The cap contains a filter to prevent particles from entering the airway and maintains the patient's own humidity. Putting the patient in the bathroom with the door closed and shower on will increase the humidity immediately. If the patient coughs up or has bright red blood mucus suctioned, or if the patient develops a fever, call your surgeon's office immediately.

How to suction

Equipment
Clean suction catheter (Make sure you have the correct size)
Distilled or sterile water
Normal saline
Suction machine in working order
Suction connection tubing
Jar to soak inner cannula (if applicable)
Tracheostomy brushes (to clean tracheostomy tube)
Extra tracheostomy tube

1. Wash your hands.
2. Turn on the suction machine and connect the suction connection tubing to the machine.
3. Use a clean suction catheter when suctioning the patient. Whenever the suction catheter is to be reused, place the catheter in a container of distilled/sterile water and apply suction for approximately 30 seconds to clear secretions from the inside. Next, rinse the catheter with running water for a few minutes then soak in a solution of one part vinegar and one part distilled/sterile water for 15 minutes. Stir the solution frequently. Rinse the catheters in cool water and air-dry. Allow the catheters to dry in a clear container. Do not reuse catheters if they become stiff or cracked.
4. Connect the catheter to the suction connection tubing.
5. Lay the patient flat on his/her back with a small towel/blanket rolled under the shoulders. Some patients may prefer a sitting position which can also be tried.
6. Wet the catheter with sterile/distilled water for lubrication and to test the suction machine and circuit.
7. Remove the inner cannula from the tracheostomy tube (if applicable). The patient may not have an inner cannula. If that is the case, skip this step and go to number 8.

   a. There are different types of inner cannulas, so caregivers will need to learn the specific manner to remove their patient's. Usually rotating the inner cannula in a specific direction will remove it.

   b. Be careful not to accidentally remove the entire tracheostomy tube while removing the inner cannula. Often by securing one hand on the tracheostomy tube?s flange (neck plate) one can/ will prevent?accidental removal.

   What is the priority intervention when performing oropharyngeal suctioning for a patient who is receiving oxygen by facemask?

   What is a priority intervention when performing oropharyngeal suctioning for a patient who is receiving oxygen by face mask? Complete the suctioning process in 20 seconds or less. Keep the oxygen mask near the patient's face during the suctioning procedure.

   Which piece of equipment should the nurse use to perform oropharyngeal suctioning?

   Gather supplies: Yankauer or suction catheter, suction machine or wall suction device, suction canister, connecting tubing, pulse oximeter, stethoscope, PPE (e.g., mask, goggles or face shield, nonsterile gloves), sterile gloves for suctioning with sterile suction catheter, towel or disposable paper drape, nonsterile ...

   Which action would the nurse perform when preparing to suction a patients oropharynx quizlet?

   Which action would the nurse perform when preparing to suction a patient's oropharynx? Place the patient in a semi-Fowler's or sitting position. After oropharyngeal suctioning, what does the nurse do with the supplies? Place the Yankauer catherter in a clean, dry area.