1. Assess patient breathing pattern or breath sound.

This might indicate accumulation of

secretion in the airway

2. Explain the procedure entails to the patient/S.O. “Good morning Ma'am today I am going
to perform suctioning. This procedure will help us to remove secretion from your airway
and will help with your ventilation and this will also help avoid infection.”

3. Prepare necessary supplies and bring at bedside:

● Suction apparatus
● Sterile suction catheter with suction port
● Sterile saline/sterile water
● Sterile container
● Sterile gloves
● Clean towel
● Stethoscope

4. Wash hands

B. SKILLS – 60%

5. Properly position the patient:

For conscious patient
○ Semi-fowler’s position with head turned to one side for oral suctioning.
○ Semi-fowler’s position with neck hyperextended for nasal suctioning.

For unconscious patient

○ Lateral position facing the nurse.

6. Place a towel on the pillow or under the patient’s chin to avoid sudden head
repositioning that may tighten the pharyngeal.

7. Turn the suction “ON”: to the appropriate pressure if applicable.

8. Pour sterile water or NSS into a sterile container.

9. Peel back the wrapper of the catheter until the adapter is exposed.

10. Pre-oxygenated patient with 100% oxygen for 1-2 minutes.

11. Apply a sterile glove to your dominant hand and clean the glove with a non-dominant
hand. Remove the wrapped around the catheter with the non-dominant hand (un-sterile
hand). Coil the catheter around your dominant hand (sterile hand) using fingers as you
remove it from the wrapper.
12. Holding the sterile suction catheter with dominant hand, connect the distal end of the
catheter to the suction that is held with the non-dominant hand.

13. Approximate the distance between the patient’s earlobe and tip of the nose to thyroid
cartilage and place the thumb and forefinger of the dominant hand at that point about 6-8
inches.

14. Moisten the catheter tip with sterile solution. Apply suction with a catheter tip in the
solution.

15. Suction:
○ For nasopharyngeal suctioning, gently insert a catheter into one nostril. Guide the
catheter medially along the floor of the nasal cavity. Do not force the catheter. If
one nostril is not patent, try the other. Do not apply suction during insertion.
○ For Oropharyngeal suctioning, gently insert the catheter into one side of the
mouth and slide the catheter to the oropharynx. Do not apply suctioning during
insertion.

16. Apply suction by occluding the suction control port with the thumb of non-dominant hand.
Gently rotate the catheter with the thumb and index finger of the dominant hand as you
withdraw it.

17. Flush the catheter with sterile solution by placing it in the solution and apply suction.

18. If the patient is able, ask them to deep breathe and cough between suctions. If
suctioning is needed, repeat step (from moistening the catheter tip).

19. When the procedure is completed, turn the “OFF” suction machine. Dispose gloves and
catheter properly. Wash your hands.

20. Offer oral hygiene. Place the patient in a comfortable position. Empty suction collection
bottle frequently.

21. Use auscultation to listen to the chest to assess the effectiveness of suctioning.

22. Record the time of suctioning, amount, consistency, color and odor of secretions, and
the patient’s response to the procedure.

23. Empty suction bottle at the end of every shift.