HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 11-8
Pediatrics: Naso/Oropharyngeal Suctioning __RN
PURPOSE:
To remove secretions blocking the trachea and to
maintain an open airway.
CONSIDERATIONS:
1. Cardiac arrhythmias, vagal stimulation, and
laryngospasm may occur.
2. Oxygen depletion may occur.
3. Suction should not last more than five seconds in an
infant, 15 seconds in an older child. Supplemental
oxygen may need to be given before and after the
procedure.
4. Suction apparatus should be set at 50 to 95mm Hg
(3-5in. Hg) for infants and 90 to 115mm Hg (5-10in.
Hg) for children.
5. Suction apparatus should be cleansed and tubing
changed at least every 24 hours according to
durable medical equipment vendor's protocol.
EQUIPMENT:
Gloves
Suction apparatus capable of producing negative
pressure (standard is 80mm of pressure, range is
from 40 to 100mm)
Container for secretions
Suction catheter (size 6, 8, or 10 French)
Clean containers for rinsing catheters
Normal saline solution
Sterile water
Impervious trash bag
Supplemental oxygen
PROCEDURE:
1. Adhere to Universal Precautions.
2. Gather all equipment.
3. Explain procedure to caregiver and patient, if age
appropriate.
4. Turn on suction to check system and regulate
pressure, if indicated.
5. Set up saline cup and open catheter.
6. Position the child facing straight ahead with his/her
head slightly tilted back. The infant should be
placed with chin up, head tipped slightly backward.
7. Determine how far to insert the catheter. Measure
the catheter using the distance between the tip of
the nose and the ear lobe.
8. Lubricate catheter tip with sterile water or saline.
9. Leaving the vent in the catheter open, insert the
catheter into the external nares, point the catheter
upward to the septum, then downward.
10. If obstruction is encountered, do not force, but
remove and insert at another angle or try the other
nostril.
11. For suctioning, intermittently occlude vent with the
thumb. Slowly rotate the catheter between the
thumb and finger of the other hand while removing
the catheter. Never suction for more than five
seconds in an infant, 15 seconds in an older child at
one time. Allow one to two minutes to recover
and/or re-oxygenate with supplemental oxygen.
12. Monitor the child's heart rate and color throughout
the procedure.
13. Repeat steps 9-12 in other nostril.
14. Last, suction oral secretions.
15. Remove the catheter slowly when suctioning is
completed. Clean the catheter and connecting
tubing by aspirating remaining sterile water or saline
solution.
16. Turn off suction. Disconnect catheter.
17. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Color of patient.
b. Consistency of color and amount of secretions.
c. Patient's tolerance of procedure.
d. Changes in vital signs or complications that
may have occurred.
e. Instructions given to caregiver.
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