College of Health Sciences Education

3rd Floor, DPT Building

Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

Name of Procedure: Oral Suctioning

Definition: Oral suction is the use of a rigid plastic suction catheter, known as a yankauer
and to remove pharyngeal secretions through the mouth.

Purposes: 1. To maintain a patent airway and improve oxygenation by removing mucous

secretions and foreign material (vomit or gastric secretions) from the mouth and
throat (oropharynx).

Materials Needed: 1. Suction apparatus

2. Sterile suction catheter (with suction control port)
3. Sterile water or saline
4. Sterile container
5. Sterile gloves
6. Clean towel
7. 5 cc. syringe (for tracheostomy suctioning)
8. Mask

STEP BY STEP PROCESS OF THE PROCEDURE

ACTION RATIONALE
Nasal Catheter
1. Assess the patient's need for suctioning Baseline respiratory assessment, including an
(respiratory assessment for signs of O2 saturation level, can alert the health care
hypoxia), the risk for aspiration, and the provider to worsening conditions.
inability to protect their airway or clear
secretions adequately, which may lead to
upper airway obstruction.
2. Explain to the patient how the procedure This allows patient time to ask questions and
will help clear out secretions and will only increase compliance with the procedure.
last a few seconds. If appropriate, Minimizes fear and anxiety.
encourage the patient to cough.
3. Position the patient in a semi-Fowler’s This facilitates ease of suctioning.
position with the head turned to the side. Unconscious patients should be in the lateral
position.
4. Perform hand hygiene, gather supplies, This prevents the transmission of
and apply non-sterile gloves. Apply a microorganisms.
mask if a body fluid splash is likely to
occur.
5. Fill bottle with water. Water is used to clear connection tubing in
between suctions. Fill the bottle with enough
water to clear the connection tubing at least
three times.
6. Attach one end of connection tubing to This prepares equipment to function
the suction machine and the other end to effectively.
the yankauer.
7. Turn on suction to the required level. Suction levels for adults are 100-150 mmHg on
Test function by covering hole on the wall suction and 10-15 mmHg on portable

yankaeur with your thumb and suctioning
up a small amount of water.
8. Remove the patient’s oxygen mask if
present. Nasal prongs may be left in
place. Place a towel on the patient’s
chest.
9. Insert the yankauer catheter and apply
suction by covering the thumb hole. Run
the catheter along the gum line to the
pharynx in a circular motion, keeping
yankauer moving. Encourage the patient
to cough. Apply suction for a maximum of
10 to 15 seconds. Allow the patient to
rest in between suction for 30 seconds to
1 minute.
10. If required, replace oxygen on the patient
and clear out the suction catheter by
placing Yankauer in the basin of water.
11. Reassess and repeat oral suctioning if
required.
12. Reassess respiratory status and O2
saturation for improvements. Call for help
if any abnormal signs and symptoms
appear.
13. Ensure the patient is in a comfortable
position and the call bell is within reach.
Provide oral hygiene if required.
14. Clean up supplies, remove gloves, and
wash hands. Document procedure
according to hospital policy.
College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117
suction units. Always refer to hospital policy for
suction levels.
Always be prepared to replace the oxygen if
the patient becomes short of breath or has
decreased O2 saturation levels.
The towel prevents the patient from coming in
contact with secretions.
Movement prevents the catheter from
suctioning to the oral mucosa and causing
trauma to the tissues.
Replace oxygen to prevent or minimize
hypoxia. Clearing out the catheter prevents the
connection tubing from plugging.
Compare pre- and post-suction assessments
to determine if the intervention was effective.
Compare pre- and post-suction assessments
to determine if the intervention was effective.
This promotes patient comfort.
Cleanup prevents the transmission of
microorganisms. Documentation provides
accurate details of response to suctioning and
clear communication among the health care
team.
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

PROCEDURE CHECKLIST on
ORAL SUCTIONING

Name: _______________________________________________________Rating:___________________
Year Level:______________________________ Code: ___________ Date Performed:________________

Procedure 5 4 3 2 1 Remarks

1. Assess patient need for suctioning

(respiratory assessment for signs of
hypoxia), risk for aspiration, and inability to
protect own airway or clear secretions
adequately, which may lead to upper
airway obstruction.
2. Explain to patient how the procedure will
help clear out secretions and will only last
a few seconds. If appropriate, encourage
patient to cough.

3. Position patient in semi-Fowler’s position

with head turned to the side.
4. Perform hand hygiene, gather supplies,
and apply non-sterile gloves. Apply mask if
a body fluid splash is likely to occur.
5. Fill bottle with water.
6. Attach one end of connection tubing to the
suction machine and the other end to the
yankauer.
7. Turn on suction to the required level. Test
function by covering hole on the yankauer
with your thumb and suctioning up a small
amount of water.
8. Remove patient’s oxygen mask if present.
Nasal prongs may be left in place. Place
towel on patient’s chest.
9. 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.
Encourage patient to cough. Apply suction
for a maximum of 10 to 15 seconds. Allow
patient to rest in between suction for 30
seconds to 1 minute.
10. If required, replace oxygen on patient and
clear out suction catheter by placing
yankauer in the basin of water.
11. Reassess and repeat oral suctioning if
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

required.
12. Reassess respiratory status and O2
saturation for improvements. Call for help
if any abnormal signs and symptoms
appear.
13. Ensure patient is in a comfortable position
and call bell is within reach. Provide oral
hygiene if required.
14. Clean up supplies, remove gloves, and
wash hands. Document procedure
according to hospital policy.
TOTAL SCORE: 70 points
Total Score ÷ Raw Score x 85 + 15 =_______%+
25% Evaluation Rating = Final Rating

LEGEND:

1 - Poor (NOT What is EXPECTED) Unacceptable

2 - Below Average (SORT of What is EXPECTED) Poor
3 - Average (ALMOST What is EXPECTED) Satisfactory
4 - Above Average (What is EXPECTED) Good
5 - Excellent (MODEL performance)

Remarks:

_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

____________________________________________ ____________________________________
Signature Over Printed Name of CIinical Instructor Signature Over Printed Name of Student
Date: _________________________________ Date: ____________________________
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

Name of Procedure: Nasal Suctioning

Definition: Nasal suctioning is the aspiration and or removal of secretions from the airway
via the nasal passage and pharynx without a tracheal tube or tracheostomy.

Purposes: 1. To remove secretions from the pharynx by a suction catheter inserted through
the nostril.

Materials Needed: 1. Wall suction or portable suction unit

2. Connecting tubing
3. Sterile normal saline solution
4. Disposable sterile container
5. Sterile suction catheter (#10 to #16 French for an adult)
6. Sterile gloves
7. Clean gloves
8. Goggles
9. Nasopharyngeal or oropharyngeal airway (optional for frequent suctioning)
10. Overbed table
11. Waterproof trash bag
12. Towel
13. Optional: tongue blade, tonsil tip suction device

STEP BY STEP PROCESS OF THE PROCEDURE

ACTION RATIONALE
1. Assess patient need for suctioning Baseline respiratory assessment, including an
(respiratory assessment for signs of O2 saturation level, can alert the health care
hypoxia), risk for aspiration, and inability provider to worsening condition.
to protect own airway or clear secretions
adequately, which may lead to upper
airway obstruction.
2. Explain to patient how the procedure will This allows patient time to ask questions and
help clear out secretions and will only increase compliance with the procedure.
last a few seconds. If appropriate, Minimizes fear and anxiety.
encourage patient to cough.
3. Position patient in semi-Fowler’s position This facilitates ease of suctioning.
with head turned to the side. Unconscious patients should be in the lateral
position.
4. Perform hand hygiene, gather supplies, This prevents the transmission of
and apply non-sterile gloves. Apply mask microorganisms.
if a body fluid splash is likely to occur.
5. Attach one end of connection tubing to This prepares equipment to function
the suction machine and the other end to effectively.
the suction catheter.
6. Turn on suction to the required level. Suction levels for adults are 100-150 mmHg on
Test function by covering hole on the wall suction and 10-15 mmHg on portable
suction catheter with your thumb and suction units. Always refer to hospital policy for
suctioning up a small amount of water. suction levels.
7. Remove patient’s oxygen mask or nasal Always be prepared to replace the oxygen if
prongs if present. Place towel on patient becomes short of breath or has
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

patient’s chest. decreased O2 saturation levels.

The towel prevents patient from coming in
contact with secretions.
8. Using strict aseptic technique, open the Movement prevents the catheter from
suction catheter kit or the packages suctioning to the oral mucosa and causing
containing the sterile catheter, container, trauma to the tissues.
and gloves. Don the gloves; consider
your dominant hand sterile and your
nondominant hand nonsterile. Using your
nondominant hand, pour the saline
solution into the sterile container.
9. Pick up the catheter with your dominant
(sterile) hand and attach it to the
connecting tubing. Use your
nondominant hand to control the suction
valve while your dominant hand
manipulates the catheter.
10. Lubricate 3" to 4" of the catheter tip with Lubrication prevents mucosal trauma when
irrigating solution. catheter is inserted.
11. Instruct the client to cough and breathe Coughing helps loosen secretions and may
slowly and deeply several times before decrease amount of suction necessary, while
beginning suction. deep breathing helps minimize or prevent
hypoxia.
12. Using intermittent suction, withdraw the Apply suction for only 10 to 15 seconds at a
catheter from the nose with a continuous time to minimize tissue trauma.
rotating motion to minimize invagination
of the mucosa into the catheter's tip and
side ports.
13. Between passes, wrap the catheter
around your dominant (sterile) hand to
prevent contamination and clear the
lumen of the catheter by dipping it in
water and applying suction.
14. Repeat the procedure, up to 3 times, until Allow 30 seconds to 1 minute to allow re-
gurgling or bubbling sounds stop and oxygenation and re-ventilation.
respirations are quiet.
15. If the client has no history of nasal If repeated nasopharyngeal suctioning is
problems, alternate suctioning between required, the use of a nasopharyngeal or
nostrils to minimize traumatic injury. oropharyngeal airway will help with catheter
insertion, reduce traumatic injury, and promote
a patent airway.
16. After completing suctioning, pull your Glove removal reduces transfer of
sterile glove off over the coiled catheter microorganisms.
and discard it and the nonsterile glove
along with the container of water.
17. Flush the connecting tubing with normal To remove secretions on the suction catheter.
saline solution.
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

18. Discard the used items and replace with Having the supplies at the bedside facilitates a
new supplies so they will be ready for the quick response
next suctioning
19. Remove personal protective equipment Handwashing reduces transfer of
and wash your hands. microorganisms.
20. Let the client rest after suctioning while To prevent hypoxia.
continuing to observe. The frequency
and duration of suctioning depend on the
client's tolerance for the procedure and
on any complications.
21. Record the date, time, reason for For proper documentation.
suctioning, and technique used; amount,
color, consistency, and odor (if any) of
the secretions; the client's respiratory
status before and after the procedure;
any complications and the nursing action
taken; and the client's tolerance for the
procedure.

PROCEDURE CHECKLIST on
NASAL SUCTIONING
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

Name:__________________________________________ Rating:_________________

Year Level:_____________ Course/Code:_____ Date Performed:_________

Procedure 5 4 3 2 1 Remarks
1. Determine the need for oxygen treatment by
performing respiratory assessment verifying the
order for treatment.
2. Wash your hands then assemble equipment.
3. Identify and explain the procedure to the client
4. Assist the client to a semi-Fowler’s position if
possible.
5. Open the oxygen valve to ensure proper
functioning.
6. Regulate the liter gauge as prescribed.
7. Remove patient’s oxygen mask or nasal prongs if
present. Place towel on patient’s chest.

8. Using strict aseptic technique, open the suction

catheter kit or the packages containing the sterile
catheter, container, and gloves. Don the gloves;
consider your dominant hand sterile and your
nondominant hand nonsterile. Using your
nondominant hand, pour the saline solution into
the sterile container.
9. Pick up the catheter with your dominant (sterile)
hand and attach it to the connecting tubing (Fig.
2). Use your nondominant hand to control the
suction valve while your dominant hand
manipulates the catheter.
10. Lubricate 3" to 4" of the catheter tip with irrigating
solution.
11. Instruct the client to cough and breathe slowly
and deeply several times before beginning
suction.
12. Using intermittent suction, withdraw the catheter
from the nose with a continuous rotating motion
to minimize invagination of the mucosa into the
catheter's tip and side ports.
13. Between passes, wrap the catheter around your
dominant (sterile) hand to prevent contamination
and clear the lumen of the catheter by dipping it
in water and applying suction.
14. Repeat the procedure, up to 3 times, until
gurgling or bubbling sounds stop and respirations
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

are quiet.
15. If the client has no history of nasal problems,
alternate suctioning between nostrils to minimize
traumatic injury. If repeated nasopharyngeal
suctioning is required, the use of a
nasopharyngeal or oropharyngeal airway will help
with catheter insertion, reduce traumatic injury,
and promote a patent airway.
16. After completing suctioning, pull your sterile glove
off over the coiled catheter and discard it and the
nonsterile glove along with the container of water.
17. Flush the connecting tubing with normal saline
solution.
18. Discard the used items and replace with new
supplies so they will be ready for the next
suctioning.
19. Remove personal protective equipment and wash
your hands.
20. Let the client rest after suctioning while
continuing to observe. The frequency and
duration of suctioning depend on the client's
tolerance for the procedure and on any
complications
21. Record the date, time, reason for suctioning, and
technique used; amount, color, consistency, and
odor (if any) of the secretions; the client's
respiratory status before and after the procedure;
any complications and the nursing action taken;
and the client's tolerance for the procedure.
TOTAL SCORE: 105 points
RATING: Total Score + Raw Score X 85 + 15 = ____X 75% +
25% Evaluation Rating
LEGEND:

1 - Poor (NOT What is EXPECTED) Unacceptable

2 - Below Average (SORT of What is EXPECTED) Poor
3 - Average (ALMOST What is EXPECTED) Satisfactory
4 - Above Average (What is EXPECTED) Good
5 - Excellent (MODEL performance)

Remarks:_____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
 College of Health Sciences Education
3rd Floor, DPT Building
Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 117

____________________________________________ ____________________________________
Signature Over Printed Name of CIinical Instructor Signature Over Printed Name of Student
Date: _________________________________ Date: ____________________________