Removal of secretions from the airways, when the patient is unable to expel them on his own, by introducing an aspiration catheter into the patient’s oral and tracheal airway.
Objectives:
– To maintain the patency of the patient’s airway. – To achieve the elimination of secretions obstructing the airway to facilitate respiratory ventilation. – To prevent respiratory infections as a consequence of the accumulation of secretions. – Facilitate the collection of specimens.
Equipment:
– Vacuum aspirator. – Tray. – Oxygen intake. – Flow meter. – Vacuum gauge. – Connector tube. -Phonendoscope. – Manual resuscitator with reservoir.
Material:
– Sterile suction probes of the appropriate number. – Container for secretions. – Sterile gloves. – Sterile gauze. – Mask. – Washing solution: sterile water or sterile saline solution. – Soaker. – Disposable gowns. – Waste bag. – Disposable paper towelettes. – Oxygen mask. – Sterile lubricant. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Inform the patient of the procedure to follow. – Ask the patient and family to cooperate. – Connect the aspirator and the suction equipment. Check its correct functioning. – Choose the appropriate probe size. The diameter should be equal to half of the airway (adults: 12-18 F; children: 6-12 F and infants 5-6 F). – Select the appropriate pressure on the vacuum gauge: adults 115-150 mmHg, children 95-115 mmHg and infants 50-95 mmHg. – Place the patient in the semi-fowler position. If the suction is to be performed orally, place the patient with the head tilted; if nasal, place the patient’s neck in hyperextension; if the patient is unconscious, place the patient in lateral decubitus. – Place a soaker covering the pillow or under the patient’s chin. – Pre-oxygenate the patient if necessary (follow general rules for oxygen therapy management). – Put on a mask, sterile gloves and disposable gown. – Measure the distance to be introduced, between the bridge of the nose and the earlobe (approximately 1.5 m). – Lubricate the probe in the nasopharyngeal aspiration. – In case of dry secretions and mucous plugs, instill physiological saline 0.9% and hyperinflate before the aspiration procedure. – Introduce the tube without aspiration through the mouth or nose and perform intermittent aspiration when removing the tube. This maneuver should not exceed 10 seconds. – In oropharyngeal aspiration, insert the tube in the side of the oropharynx. – Clean the probe with sterile gauze and aspirate sterile saline or water. – Repeat the aspirations as many times as necessary. – Discard the probe and gloves after aspiration. – Let the patient rest between aspiration and aspiration. – Encourage the patient to take deep breaths and perform the assisted coughing procedure. – Place the patient in the most appropriate position. – Collect the material. – Remove gloves and mask. – Perform hand washing. – Record in the nursing documentation: procedure, reason, date and time, incidences, characteristics of secretions, and patient response.
Observations:
– Sterile technique. – Avoid aspiration of secretions after meals. – Use a new tube each time the aspiration maneuver is performed. – Observe for signs of respiratory or cardiac distress. – Leave spare equipment after each aspiration. – Short-term or immediate complications that may arise are: bronchospasm, hypoxemia, bradycardia, tracheal and bronchial trauma, anxiety, hypertension, hypertension, and increased intracranial pressure. In the long term, respiratory infection may occur.
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