Suctioning: Endotracheal

Critical Elements

• Maintain sterile technique throughout.
• Perform hand hygiene before and after procedure.
• Educate patient of the procedure.
• Hyperoxygenate prior to procedure.
• Apply suction no longer than 15 seconds.
• Perform procedure safely for patient.

Procedure

Prior to Treatment: (Critical Thinking)

• Assess patients need for treatment.
• Confirm order.
• Gather equipment: face shield or goggles and gown, wall suction or portable suction, gloves, suction catheter, sterile saline.

Patient Interaction: (Safety)

• Patient identifiers.
• Provide for privacy.
• Explain procedure.
• Wash hands.

Steps of the Procedure (Patient Centered Care; Safety, Infection Control)

1. Place patient in a semi-fowler’s position.
2. Place linen saver pad or towel on patient’s chest.
3. Apply personal protective equipment.
4. Turn on suction and adjust pressure according to agency policy.
5. Apply procedure glove and test the suction by occluding the connection tubing, discard glove and wash hands.
6. Open the suction catheter kit.
7. Apply sterile gloves, keeping dominant hand sterile.
8. Pour sterile saline into containers with nondominant hand.
9. Grab sterile catheter with sterile hand and place onto suction tubing without contaminating.
10. Hyperoxygenate patient according to agency policy.
11. Place catheter in sterile water, moistening.
12. Using the sterile dominant hand, gently but quickly insert the suction catheter into the endotracheal tube.
13. Advance the suction catheter with suction off, gently aiming downward and being care not to force.
14. Apply suction while withdrawing the catheter, rotate the catheter while withdrawing.
15. Apply suction no longer than 15 seconds.
16. Withdraw the catheter, placing the tip in the sterile water and clearing the tubing.
17. Repeat as needed, hyperoxygenating the patient between each pass.
18. Clear the tubing by suctioning the remaining water.
19. Dispose of equipment properly.
20. Assess respiratory status.

After Procedure (Patient Centered Care, Safety)

• Straighten room making patient comfortable, replace call light.
• Wash hands before leaving room.

Documentation (Informatics, Communication)

• Amount and color of sputum.
• Patient’s response to procedure including respiratory assessment.

Resources

• John’s Hopkins Medicine: Suctioning