11 Things to remember when suctioning
Lydia smoothens her duty uniform as she hurries toward the nurse’s station. Today is another day of learning for her. She is feeling thrilled of the thought that she, together with her classmates are assigned to go on duty in the medical ward this week. For her, it means getting to know different medical conditions and learning new procedures.
She actually likes to go on duty as for her, it is where everything she reads in books from theories, diseases to procedures, come to life. “This is how it is in reality,” she tells herself.
As she approaches the station, she hears their clinical instructor discuss something about suctioning and how they’ll be able to witness it in a few moments with the staff nurse on duty. Yes, she has heard and read about it, but she hasn’t actually experienced seeing the procedure get done in reality. She gets excited as she proceeds to the patient who is about to undergo the procedure.
She tells herself to observe intently and grab every information that she could since someday, when the right time comes and when she is licensed to practice as a Registered Nurse she’ll get to perform that procedure to numbers of patients and hopefully she’ll be able to inspire nursing students too, just like how skilled staff nurses have inspired her throughout the years.
So, you have read about suctioning for dozens of times already. You have listened to your Clinical Instructors discuss about it in lectures and ward classes, but would you actually remember those learnings when you get to perform the procedure for the first time when you’re all nervous and feeling fidgety?
Here are some of the things you should take in mind when you perform suctioning whether for the first or nth time already.
- Have the equipment needed ready at bedside: suction machine, irrigating suction, suction catheter, suction bottles. Of course, you wouldn’t want to cram and say “Hey, where is the irrigating solution?” when the time comes that it is urgently needed to perform the procedure.
- Wash your hands before the procedure. As always, aseptic technique. Also, wear protective gear such as gloves, facial mask, etc as needed.
- You can repeat this procedure. This is not a one-time procedure. You can actually repeat suctioning if necessary, but when you do so, allow your patient to catch their breath first.
- The patient should be in a sitting position for suctioning.
- Coughing is normal. Don’t panic and call for the doctor when your patient coughs when you suction. The patient will cough as the throat is entered and you will feel resistance at some point.
- Hyperoxygenate patient before and after the procedure. Or you may advise your patient to take several deep breaths before suctioning.
- Check heart rate before, during and after procedure. If tachycardia or bradycardia occurs discontinue the procedure until it resolves
- If nasotracheal suctioning is to be performed, you may coat tip of catheter with lubricant.
- When removing the catheter, apply intermittent suction and do it in a circular motion. Suction should not be applied for more than 10-15 seconds.
- Throw out catheters after use, unless you have been instructed by your nurse to clean and re-use them. Most of the suction catheters are on a single use basis only.
- Auscultate the patient’s chest; if secretions can still be heard repeat the suctioning procedure (5-10ml of normal saline may be used to loosen tenacious secretions). Before re-suctioning, clear catheter with sterile water.
Everyone, no matter how experienced and skilful they might be, always has their first time. We may feel a bit panicky and nervous on our first time to do a procedure, we may forget some concepts we have learned in that moment, but what’s imperative is that we remember certain things especially the main points when it comes to performing suctioning. That way, we won’t only know what to do, but we may also save our patients from potential harm as well.