NASOPHARYNGEAL AND OROPHARYNGEAL SUCTIONING OF THE NEWBORN

1. Identify the patient.

2. Determine the need for suctioning. Verify the suction order in the patient’s chart, if
necessary.
3. Explain rationale and procedure to child and family members. Give the option of
assisting or obtain other assistance if necessary.
4. Perform hand hygiene.
5. Assemble equipments and take to the bedside.
6. Check that the suction machine is functioning by connecting the connecting
catheter and test by suctioning water from a clean container. Correct suction pressure
is set.
7. Check that wall oxygen is functioning and that appropriately sized oxygen face mask
and tubing is accessible.
8. With the help of the caregiver or assistant, gently wrap the child with a sheet or
blanket to immobilize their arms and hands.
9. Position/lie the newborn on either side or back with the head in “sniffing” position
to facilitate and open the airway. Tilt head but do not hyperextend.
10. Wash hands, put on a disposable, clean gloves and use an aseptic non touch
technique throughout.
11. Clean the nares of mucus if suctioning is through the nose.
12. Open sterile suction package using aseptic technique and connect the end to the
suction tubing. Set it up on the work surface and pour a sterile saline into it.
13. Place a small water-soluble lubricant on the sterile field, taking care to avoid
touching the sterile field with the lubricant package.
14. Moisten the catheter by dipping it into the container of sterile water/saline.
Occlude Y-tube to check suction.
15. Estimate insertion length by holding catheter parallel to newborn and measuring
from the tip of the nose to the tragus of the ear.
16. Lubricate tip of catheter with a small water-soluble lubricant, if required.
17. Remove the oxygen delivery device, if appropriate. Do not apply suction as the
catheter is inserted. Hold the catheter between your thumb and forefinger.
18. For Nasopharyngeal suctioning
Gently insert catheter through the nares and along the floor of the nostril
toward trachea. Roll the catheter between your fingers to help advance it.
Advance the catheter approximately to reach the pharynx.

For Oropharyngeal suctioning

Insert catheter through the mouth, along the side of the mouth toward
trachea. Advance the catheter to reach the pharynx.

Apply suction by intermittently occluding the Y port on the catheter with the
thumb of your non-dominant hand and gently rotate the catheter as it is being
withdrawn. Do not suction for more than 10-15 seconds at a time.
19. Flush catheter with saline. Assess effectiveness of suctioning and repeat as needed
and according to patient’s tolerance.
20. Allow at least a 30 second to 1minute interval if additional suctioning is needed.
No more than three suction passes should be made per suctioning episode. Alternate
the nares, unless contraindicated, if repeated suctioning is required. Do not force
catheter through the nares. Suction the oropharynx after suctioning the nasopharynx.
21. Continue suctioning until no more secretions can be aspirated. Withdraw the
catheter, rinse and place in a sterile area.
22. Turn off suction. Remove supplemental oxygen placed for suctioning, if
appropriate. Assist patient to a comfortable position.
23. Empty suction collection bottle frequently.
24. Reassess patient’s respiratory status, including respiratory rate, effort, oxygen
saturation, and lung sounds.
25. Explain the effectiveness of procedure to parents and indicate how often
suctioning may be required.
26. Document procedure to patient’s chart.