| 👀 Tracheostomy Care – Managing tracheostomy and preventing infections 👀 Suctioning – Procedures for secretion removal and safe execution 👀 Oxygen Therapy – Proper oxygen usage and application to patients (Nasal Cannula, Simple Oxygen Mask, and Partial Rebreather Mask) 👀 Nebulizer Therapy – How to use nebulizers for drug delivery and their application |
Tracheal Suctioning in a Hospital Setting
Scene: Tracheal Suctioning in a Hospital Setting
Nurse:
Good morning, Mr. Brown. My name is Emily, and I’ll be your nurse today. I’ll be assisting you with a suctioning procedure to help clear your airway. This will make it easier for you to breathe and prevent secretions from building up in your lungs. I’ll walk you through every step of the process, and if at any point you feel uncomfortable or short of breath, please let me know right away.
Patient:
Good morning, Emily. Thank you for explaining it clearly. I’m ready.
Nurse:
Great! I’ll start by performing hand hygiene to reduce the risk of infection, then I’ll gather all the necessary supplies. These include sterile gloves, a sterile suction catheter, sterile saline solution, and the suction device itself.
(Nurse washes hands thoroughly and sets up the equipment on a clean surface using aseptic technique.)
Nurse:
Before we begin, I want to make sure you’re receiving enough oxygen. Suctioning can sometimes briefly lower oxygen levels, so I’ll give you a bit of extra oxygen through your face mask.
(Nurse checks oxygen flow, ensuring the patient is receiving supplemental oxygen.)
Nurse:
Next, I’ll set up the suction system. I’m slightly opening the suction catheter packaging while keeping the distal end sterile. I’m now connecting the catheter to the suction tubing and adjusting the suction pressure to a safe range for adults—between 110 and 150 millimeters of mercury.
Patient:
Will it hurt?
Nurse:
You may feel a little discomfort, like a tickling or gagging sensation, but it shouldn’t be painful. I’ll do my best to be as gentle as possible and keep the procedure quick. Since you’re awake and able to cooperate, I’ll help you into a semi-Fowler’s position—this means sitting up at about a 30–45 degree angle. This helps reduce the risk of aspiration and makes it easier to breathe during suctioning.
(Nurse adjusts the bed and supports the patient into position, ensuring the airway is aligned.)
Procedure: Tracheal Suctioning
Nurse:
Now I’ll put on sterile gloves—this step is crucial to prevent introducing bacteria into your airway. I’m putting on my left glove first, then the right, being careful not to touch anything unsterile.
(Nurse dons sterile gloves and checks that the suction catheter is still sterile.)
Nurse:
I’m now going to lubricate the catheter tip with sterile saline to make insertion smoother. Before inserting, I’m testing the catheter by briefly blocking the suction control port with my thumb and flushing a small amount of saline through it to ensure it's functioning properly.
(Nurse confirms the catheter is working.)
Nurse:
Everything looks good. I’ll now insert the catheter gently into your trachea. I’ll advance it without applying suction until I feel slight resistance, usually when the tip reaches near the carina, which is where the trachea branches into the lungs.
(Nurse inserts the catheter with a smooth, steady motion.)
Nurse:
Now I’ll apply suction by covering the control port with my thumb while slowly withdrawing and rotating the catheter. This rotation helps effectively clear secretions from all sides of the airway.
(Nurse observes the patient's facial expression, oxygen saturation, and signs of respiratory distress.)
Nurse:
You’re doing really well, Mr. Brown. I’ve completed the first suction pass. I’ll now flush the catheter with sterile saline to clean it before moving on to suctioning your mouth and nose.
(Nurse flushes the catheter and prepares for the next step.)
Procedure: Oral and Nasal Suctioning
Nurse:
Now I’ll gently suction your oral cavity and then your nasal passages to remove any residual secretions. This step is important to prevent those secretions from being inhaled back into your lungs.
(Nurse performs oral suctioning first, being careful around the gums and tongue, then follows with nasal suctioning, using a gentle technique to avoid trauma.)
Post-Suctioning Care
Nurse:
All done, Mr. Brown! I’ll now turn off the suction device and safely dispose of the catheter. I’m removing my gloves and performing hand hygiene again.
(Nurse removes gloves, washes hands, and reassesses the patient.)
Nurse:
Let me check your oxygen levels and respiratory rate to ensure you're recovering well. Your oxygen saturation looks stable, and your breathing sounds clearer now.
Patient:
Yes, I can breathe a lot easier. Thank you so much, Emily.
Nurse:
I’m really glad to hear that. I’ll now help you return to a comfortable semi-Fowler’s position and reapply your oxygen mask. Please take a few deep breaths. Let me know if you feel dizzy or lightheaded at any point.
Documentation and Patient Education
Nurse:
I’ll document the entire procedure, including the amount, color, and consistency of the secretions removed. I’ll also note how you tolerated the procedure and your current respiratory status.
Also, just so you know—suctioning is usually performed as needed, based on your oxygen levels, breath sounds, and signs of secretion buildup. If you feel short of breath or hear rattling sounds when you breathe, please use the call button. We’re here to help you at any time.
Patient:
I really appreciate the care. I’ll let you know if I need help.
Nurse:
You’re very welcome, Mr. Brown. You did a great job. I’ll check on you again soon, but don’t hesitate to call if anything changes.
Educational Notes (for nursing students):
- Indications for suctioning include visible secretions, gurgling breath sounds, decreased oxygen saturation, or difficulty breathing.
- Aseptic technique is essential to prevent introducing pathogens into the airway.
- Pre-oxygenation helps prevent hypoxia during suctioning.
- Monitoring the patient throughout the procedure is critical—observe oxygen saturation, skin color, respiratory rate, and signs of distress.
- Documentation should include procedure time, patient response, secretion characteristics, and post-care observations.
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