1. 1AL-barrak

2. 2

3. Definition:- Oronasopharyngeal suction removes secretions from the pharynx by a suction catheter inserted through the mouth or nostril. 3AL-barrak

4. To maintain a patent airway, This procedure helps the patient who can ’ t clear his airway effectively with coughing Such as the unconscious or severely debilitated patient. 4AL-barrak

5. Oronasopharyngeal suction is an aseptic procedure that requires sterile equipment. Nasopharyngeal suctioning should be used with caution in patients who have - Nasopharyngeal bleeding - Spinal fluid leakage into the nasopharyngeal area, - Receiving anticoagulant therapy, because these conditions increase the risk of bleeding. 5AL-barrak

6. 1.Oropharngel 2.Naspharngel 3.Tracheostomy & end tracheal tubes 6AL-barrak

7. Equipment Portable suction apparatus Collection bottle Connection tubing Water-soluble lubricant Normal saline solution 7AL-barrak

8. - Disposable sterile container - 12 – 14 French catheter for an adult - For an child 8 – 10 French catheter - For pediatric feeding tube for an infant - Sterile gloves - Clean gloves - Nasopharyngeal or oropharyngeal airway 8AL-barrak

9. Before beginning, 1.Check your facility's 2.Doctor ’ s order 3.Review the patient ’ s blood gas 4.Check vital signs 5.Evaluate the patient ’ s ability to cough & deep-breathe to determine her ability to move secretions 9AL-barrak

10. Explain the procedure to the patient even if she is unresponsive Inform her that suctioning may stimulate transient coughing or gagging {but tell her that coughing helps to mobilize secretions} Reassure her throughout the procedure to minimize anxiety & fear which can increase oxygen consumption 10AL-barrak

11. Wash your hands Place the patient in semi-fowler's or high fowler ’ s position, to promote lung expansion & effective coughing Turn on the suction from the portable unit, 11AL-barrak

12. Set the pressure according to your facility's policy The pressure is usually set between 80 & 120 mm hg; (higher pressure cause excessive trauma without enhancing secretion removal.) Occlude the end of the connection tubing to check suction pressure. 12AL-barrak

13. Using strict aseptic technique, open the suction catheter kit Disposable container & gloves Consider your dominant hand sterile & your non dominant hand non sterile Using your non dominate hand, pour the sterile water or saline into the sterile container 13AL-barrak

14. -With your non dominant hand, place a small amount of water- soluble lubricant on the sterile area. -The lubricant is used to facilitated passage of the catheter during nasopharyngeal suctioning. 14AL-barrak

15. Pick up the catheter with your dominant (sterile) hand, & attach it to the connecting tubing Use your non dominant hand to control the suction valve while your dominant hand manipulates the catheter. 15AL-barrak

16. Instruct the patient to cough & breathe slowly & deeply several times before beginning suction. Coughing helps loosen secretions & may decrease the amount of suctioning necessary, 16AL-barrak

17. Suction tracheal tubes 1.Explain procedure to patient 2.Collect equipment 3.Wash hands 4.Provide privacy 5.Elevate bed to working level 6. Put down side rail 7. Place patient in fowler position 8. Open & prepare sterile field, supply 9. Urn on suction machine & check pressure 17AL-barrak

18. Never suction more than 10 seconds at a time to prevent hypoxia Do not apply suction pressure during insertion catheter Pre-oxygenated the patient Wait 3 minutes interval before each suction 18AL-barrak

19. followed by hypotension related to stimulation of vague nerve Use genital insertion & manipulation of catheter Lubricate catheter before to inserting Monitor pt ’ s pulse 19AL-barrak

20. Follow strict aseptic technique Suction patient only when needs 20AL-barrak

21. Record for 1. Date, time 2. Amount, color, consistency & odor 21AL-barrak