SUCTIONING

-Devices are sometimes necessary to create suction.

Suction may be used to clear the airway of blood, saliva, vomit, or other secretions so that a patient
may breathe.

Suctioning can prevent pulmonary aspiration, which can lead to lung infections.

(Wikipedia)

-Stop suctioning neonates at birth. There is no benefit to this practice, and it can cause bradycardia
and apnea.

Instead, wipe the baby’s mouth and nose with a towel to clear excess secretions and stimulate
respiration.

Lancet. 2013;382:326–330. [PubMed] [Google Scholar]

The World Health Organization (WHO) now advises against routine bulb suctioning of neonates in
the minutes following birth.
If the baby is born through clear amniotic fluid and begins breathing on their own shortly after birth,
do not suction.

Nasal Aspirator( Rubber Suction)

Other type of suctioning

• Suctioning can be performed through an endotracheal tube, a tracheostomy tube, the

mouth, or the nose.

• There are two separate suctioning techniques, namely the closed and open system.

• Clinically ill patient

Parts of compact suction machine

ASSESSMENT:

Check the suction machine every day to make sure that the:
 suction pressure is set correctly

integrity is good, no holes, cracks, tears

filter, tubing & canister is clean

battery is fully charged

Suction Tubing Size

• if the baby struggles with signs of respiratory distress,

• do not delay suctioning.

Aspirated meconium can be especially lethal to newborns, and the faster you are able to
suction them,

• the greater their likelihood of survival.

What pressure should I suction my newborn?

• (80 - 100 mmHg)
• Recommended pressures should not exceed 80 – 120 mmHg for pediatrics
• and 80 - 100 mmHg for neonates.
REMEMBER:
• Cleanse hands and put on sterile gloves.
• This procedure is sterile technique,
• Therefore you need to do hand washing technique
• Don sterile gloving

Who needs SUCTIONING

• Newborns in respiratory distress, those with low Apgar scores, and those struggling
with the transition from fetus to newborn may still need bulb suctioning, other
serious condition such as meconium aspiration syndrome, which needs rapid
assessment and a suctioning with a machine.
What do you suction first in a newborn?
• If both the mouth and nose need to be suctioned, suction the mouth first. When
suctioning the mouth, place the tip of the bulb syringe towards the inside of your
child's cheek.
• Wash your hands before and after suctioning.
What is the correct method of suctioning?

• Insert yankauer catheter and apply suction by covering the thumb hole. Run catheter
along gum line to the pharynx in a circular motion,
• keeping yankauer moving
• Movement prevents the catheter from suctioning to the oral mucosa and causing
trauma to the tissues.

Low /poor APGAR SCORE

Meconium aspiration:
• Meconium aspiration syndrome occurs when a newborn breathes a mixture of
meconium and amniotic fluid into the lungs around the time of delivery. Meconium
aspiration syndrome, a leading cause of severe illness and death in the newborn,
occurs in about 5 percent to 10 percent of births.
Signs of respiratory distress in newborn
1. TACHYPNEA – Newborn exhibit above 60bpm of RR.
2. Retractions-The chest appears to sink in just below the neck or under the
breastbone with each breath or both.

3. Grunting-sound can be heard each time the person exhales. This grunting is the body's
way of trying to keep air in the lungs so they will stay open
4. Nasal flaring- The openings of the nose spreading open while breathing may mean that a
person is having to work harder to breathe.
5. Cyanosis – bluish discoloration of whole body.

Hyperoxygenation
• In general:
• Give oxygen for 30-60 seconds prior to suctioning.
If you must suction them repeatedly or the first suctioning attempt fails, withdraw the
catheter and oxygenate the patient again.

• What is the maximum suction time for an infant?

• Do not suction longer than 5 to 10 seconds. Let your child rest for 15 to 20 seconds
before suctioning again. If mucus is thick, lavage with 3 to 5 drops of normal saline
into the nostril before suctioning
• Suction a small amount of distilled/sterile water with the suction catheter to clear
any residual debris/secretions.
• If we need to flush your suction catheter you will need:
• A long-standing intervention during tracheostomy tube suctioning in acute care
settings is use of saline to loosen and remove respiratory tract secretions, maintain
airway patency, and prevent mucus plugs.

What are nursing interventions for suctioning?

• Do Not Suction Too Long. Prolonged suctioning increases the risk of hypoxia and
other complications. Never suction a patient for longer than 10 seconds. Rather than
prolonged suctioning, withdraw the catheter, re-oxygenate the patient, and suction
again.
• Depth of Oral suctioning up to pharyngeal area= OROPHARYNGEAL SUCTIONING
• Indicator for successful newborn suctioning:
A RISE in the HEART RATE ( < 100 bpm )is the most important indicator of effective
ventilation and response to resuscitative interventions.

What is the indication for newborn resuscitation?

If the infant's heart rate is absent or if after 30 seconds of effective ventilation the
heart rate remains below 60 bpm, cardiac resuscitation should be initiated.
Heart rate can be assessed by listening with a stethoscope over the precordium or
feeling for pulsations at the base of the umbilical cord.
• VIDEO
https://www.youtube.com/watch?v=zFq63SA7jsE

THANK YOU : ROWENA M. PUNZALAN ,MAN