Page 210 - Clinical Application of Mechanical Ventilation

176 Chapter 6

TABLE 6-8 Endotracheal Suctioning

Procedure Rationale

Wash hands and gather all suction supplies Avoid need to obtain other supplies once
(catheter, sterile gloves, water, water sterile gloves have been put on hands.
container, and saline solution).

Explain procedure to patient. Assure patient understanding and cooperation.
Adjust vacuum to 100 mm Hg. Prevent excessive vacuum and mucosal
damage.

Put sterile water in container. For testing suction device and flushing
secretions inside catheter.

Put on sterile gloves using aseptic technique. Minimize nosocomial infection.
Designate “sterile” and “contaminated” hands. Use sterile hand to handle all supplies
requiring aseptic technique (i.e., suction
catheter).
Use contaminated hand to handle all other
supplies (e.g., ET tube adaptor, suction tubing).

Attach suction catheter (sterile hand) to Ensure sterile and aseptic techniques.
suction tubing (contaminated hand).

Test vacuum and suction with sterile water. Ensure proper function of suction setup.
Remove ET tube adaptor and irrigate with Loosen secretions.
5 mL of sterile saline or mucolytic agent only
if indicated (contaminated hand).
Manually hyperinflate the patient’s lungs with Ensure adequate ventilation and oxygenation.
resuscitation bag. Seek help if necessary.
Insert catheter into ET tube (sterile hand) and Avoid suctioning the tracheal wall and
advance until resistance is met. Withdraw minimize mucosal damage.
catheter slightly.
Activate suction (contaminated hand) and Increase removal of secretions.
withdraw catheter (sterile hand) by rotating
the catheter.
Limit the duration of suction from 10 to 15 sec Prevent suction-induced hypoxia and
for adults (5 sec for children) arrhythmias.
Auscultate chest and repeat suction if Avoid unnecessary suctioning.
necessary.
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