An 87-year-old client requires long-term ventilator therapy. He has a tracheostomy in place and requires frequent suctioning. Which of the following techniques is correct?
A. Using intermittent suction while advancing the catheter.
B. Using continuous suction while withdrawing the catheter.
C. Using intermittent suction while withdrawing the catheter.
D. Using continuous suction while advancing the catheter.
Correct Answer: C. Using intermittent suction while withdrawing the catheter.
Intermittent suction should be applied during catheter withdrawal. To prevent hypoxia, suctioning shouldn’t last more than 10-seconds at a time. Suction shouldn’t be applied while the catheter is being advanced. Ensure preoxygenation with 100% FiO2 was done with adequate pulse oximetry measurements. Preoxygenation is required because airway suctioning procedure may be associated with significant hypoxemia.
Option A: Suctioning of the lower airways should be done in a sterile manner with single-use gloves and suction catheters to prevent contamination and secondary infection. The catheter should be introduced to a depth no more than the tip of the artificial airway to prevent trauma and bleeding from airway mucosa.
Option B: Suction pressure should be kept less than 200 mmHg in adults. It should be set at 80 mmHg to 120 mmHg in neonates. The catheter size used for suction should be less than 50% of the internal diameter of the endotracheal tube. A common conversion is that a 1 mm diameter is equal to a 3 French.
Option D: The duration of suctioning should be less than 15 seconds per suction attempt. Following airway suction, the patient should be allowed to recover for at least 10 to 15 seconds and re-oxygenate as needed before re-suctioning occurs. Standard precautions should be followed while suctioning by the care provider.
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