1. Suction, Oxygen and Saturation Monitoring
Leanne Turner
Carol Lawrence
Mandy Parker
&

2. Why are we doing this training
Liverpool long term suction pathway
Audit results
Issues with schools training
Issues with equality of training
Issues with machine maintenance
Issues with maintenance training
Issues with retraining
Issues with poor technique
Care Plans
Impact on the child and family!!!

3. What will be covered today
Professional responsibility
Learning styles
Teaching Suction- Training Pathway, package for training, assessment, good technique and suction maintenance
Teaching Oxygen- Training Pathway, Package for training, assessment
Teaching saturation monitoring
OSCE assessment

4. Suction Teaching and assessment pathways NP suction Oral suction
General Oral Suction/Oxygen
training for school staff

5. Look at the Suction plan
When do I need suction?
When you can hear and feel secretions and I’m distressed by them
When my saturations are low
When I’m working harder with my breathing
When I’m coughing but not clearing secretions
How can you make suctioning easier for me?
Explain to me what you are doing
Talk to me as you do it so I know it is nearly over
How do I get suctioned?
Suction pressure– 150mmHg/ 20KPa
I am suctioned via my tracheostomy. I use size 10 suction catheters down to a depth of 7.5. I sometimes require suction in my nose or mouth
How often do I get suctioned when I’m well?
This is vary variable as every day is different but if I’m unwell my secretions change in colour and are thicker
What are my secretions like when I’m well?
Loose white/clear secretions
What machines can be used and where are they stored?
Sam 12 - at home
De Vilbiss - portable
Contacts for suctioning
BME Alder Hey– Machine maintenance
Telephone–
Community nurses– Consumables/Training
Telephone–
Community respiratory Physiotherapist
Telephone–

6. Suction assessments and Care Plans
Plans to reduce risk and effectiveness of technique
Community respiratory physiotherapy team
Suction and oxygen assessment
Joint care planning with Oxygen nurse specialist
Oxygen and Suction care plan
This means:-
Clear guidance for people teaching
Child specific needs identified to personalise teaching

7. Stage 1 Training Suction awareness session Overview of anatomy
Indications
Hazards
Respiratory Assessment
Pressure setting
Technique
Practice of technique
Machine maintenance including consumables
STANDARDISED TEACHING PACKAGE NP & ORAL
Presentation, Workbook (if required), OSCE & Competency Ax
SUCTION MAINTAINENCE CHECKLIST STANDARD FOR BOTH

8. Stage 2 Training Mentoring of practice Monitoring
Questioning/Challenging
Correcting technique and improve knowledge
Preparation for assessment using competency framework and OSCE as a guide

9. Assessment
Suction competency framework- NP/Oral
Practical Ax- OSCE assessment- NP/Oral
COMPETENT VS GOOD QUALITY.
We want good quality as this improves the child’s outcomes!!!!!!!!!!

10. What does good technique look like?

11. Common areas to look out for
Hand washing
No child preparation
Depth
Incorrect size catheter
Repetitive catheter use
Speed-NP
Contamination
Catheter at nose-NP
Pressure
Blind sweeping-Oral

12. Suction Maintenance Checklist Different Machines CQC Servicing
Set ups- New equipment- new lids

14. Current New

15. Incidents with new lids
Child without suction machine all day in school
Child on holiday without suction machine for 4 days
2 children unable to set up and use machine on delivery of consumables
Training Issue

16. Bending catheters make them hard to use
Consumables.
Where do you get them-CCNT/GP
How to store them- yankauer cover, catheters no pre attachment and avoid bending
 Bending catheters make them hard to use
Cover for infection control
Wallace Tubing- change Weekly
Filter- change 3 monthly
Suction catheters- change after each use
 Can use twice NP but must not touch anything in between. Never Mouth to Nose and avoid nose to mouth
Yankauers- change daily
Spares required to go into school/Respite/Out and about
 Incase broken/ dropped

17. Leave on charge before going out
Machine.
Power light indicator.
Battery Charger/Car Charger-Importance of going out- no red.
 Leave on charge before going out
Checking power/Charging.
 red light always flicks on when switched on but most not stay on
Checking suction pressure- finger over end or kinking tube
 Kinking tube handy for yankauer as no need to disconnect. Also infection control
Adjusting suction pressure.
 Do not press in the button just turn it otherwise it effects setting accuracy
Ideal Pressure- 20KPa/ mmHg.- check and recheck
Places where it might break (lid, right angle cold weather, tubing)
Who to call if your machine is broken- BME/Community Equipment Stores/ CCNT
 label will indicate who to ask. BME never in weekend so CCNT then

18. Never wash filters new or old system
Cleaning.
Bag- 40 degree washing machine.
Machine- wipe down warm soapy water
 no excessive water just damp cloth. Care with filters as if wet or damp wont work
Canister-full clean daily. New collection bottles do not wash filter connector. Empty when more than half full
 Never wash filters new or old system
Empty more than half full as will effect pressure if nearly full. Especially important when going out
After use flushing- tap water.
 sterile water no longer required.

19. Yearly update OSCE and Competency framework
Suction Maintenance Checklist
Retraining with identified training plan for individual after reassessment if not achieving competency