7.13 : Suctioning the Oropharyngeal Airway

In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.

After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the transmission of pathogens and safeguard the patient and themselves. The patient must be accurately identified using two separate identifiers to avoid procedural errors.

Closing the curtains around the bed ensures privacy, and the patient is informed about the procedure.

The nurse then adjusts the suction unit's pressure, which must be carefully calibrated to avoid trauma and hypoxemia. It is done by setting the pressure dial to the recommended levels: 100-120 mmHg for adults, 80-100 mmHg for children, and 60-80 mmHg for infants. Lower pressures may be necessary for portable units.

An aseptic technique is used to open the suction package and prepare a sterile field, ensuring the catheter and supplies are not contaminated. The nurse lubricates the catheter's first 2 to 3 inches with water-soluble lubricant to protect the mucosal lining.

The nurse may increase the patient's supplemental oxygen before and after suctioning to mitigate the risk of hypoxemia.

The catheter is then carefully inserted into the oropharynx while applying intermittent suction to minimize mucosal damage. Suction is used only during withdrawal, accompanied by a rotating motion to remove secretions more effectively. Suction should be limited to 10 to 15 seconds.

After suctioning, the catheter is rinsed with saline to eliminate any remaining secretions. The patient is then evaluated for the need for further suctioning based on the secretions' volume and nature and the patient's respiratory condition.

After completing the procedure, the nurse disposes of gloves and the catheter appropriately, then thoroughly cleans and reorganizes the equipment to ensure a safe and organized environment. The nurse documents the procedure details in the patient's medical record, including any observations or issues. The patient's respiratory status is reassessed to detect potential complications, and hand hygiene is repeated to maintain infection control standards.