Tracheobronchial Suctioning

  1. Suction removal of secretions from the tracheobronchial tree using a sterile catheter inserted into the airway
  2. Catheters may be inserted through various routes: nasopharyngeal, oropharyngeal, or via an artificial airway.
  3. Purposes
    1. Maintain a patent airway through removal of secretions.
    2. Promote adequate exchange of oxygen/carbon dioxide
    3. Substitute for effective coughing
    4. Obtain a specimen for analysis
  4. Procedure
    1. Gather suctioning equipment (receptacle for secretions, sterile catheter, sterile gloves, and container of sterile normal saline).
    2. Turn vacuum on and test suction system.
    3. Place client in semi- to high-Fowler's position.
    4. Apply sterile glove, fill sterile cup with solution, and attach sterile catheter to connecting tube.
    5. Increase inspired oxygen concentration to highest point and hyperinflate the lungs before and after each catheter insertion by using self-inflating bag; have client deep breathe if able.
    6. Use gloved hand to insert catheter.
      1. Oral route
        1. if oral airway in place, slide the catheter alongside it and back to the pharynx; if no oral airway in place, have client protrude the tongue and guide the catheter into the oropharynx.
        2. insert during inspiration until cough is stimulated or secretion obtained.
      2. Nasal route: advance catheter along the floor of the nares or pass it through an artificial nasal airway until cough is stimulated or secretions obtained.
      3. Artificial airway: insert the catheter into the artificial airway until cough is stimulated or secretions obtained.
    7. Do not cover the thumb control and do not apply suction during insertion of the catheter.
    8. During withdrawal, rotate the catheter while applying intermittent suction.
    9. Whole suctioning procedure including insertion and removal of the catheter should not exceed 10 seconds.
    10. If it is necessary to continue the suctioning process, hyperinflate the lungs, allow the client to rest briefly, and repeat the process.
    11. Discard catheter, glove, and cup; record amount, color, characteristics of the secretions obtained; note client's tolerance of procedure.