Nasopharyngeal suction

1
Nasopharyngeal suction

• Education pack 13
• Liz Herd

2
Ground rules

• We value the young people we care for we would
  never put them or you at risk
• Always ask any questions when they occur to you,
  weve all asked questions that may seem
  silly-there is no such thing as a silly question!
• Stop me if you dont understand- the chances are
  others dont either
• Tell me if you need a break

3
Objectives for carers

• To recognise and select appropriate equipment for
  child/young person
• Carer to understand the risks of doing/not doing
  suction
• Carer to demonstrate good technique
• Carer to recognise child/young persons dignity
  throughout procedure

4
Aims

• To provide safe suction to child/young person
• To lessen the risks to the child/young person
• To prevent the introduction of infection
• To lessen the discomfort of procedure
• To recognise when suction is appropriate or not

5
What is nasopharyngeal suction?

• The aim is to clear the nasopharynx and ensure
  clear airway
• The catheter is passed up a nostril and into the
  post nasal space until a cough is solicited no
  further

6
Can be uncomfortable!

• To reduce chance of discomfort
• Extend the neck if possible -70º
• Insert the suction catheter along the top of the
  nose so the catheter follows the curve of the
  bridge of the nose and does not bang into it!!
• It is painful if the bridge of the nose is struck
  and will NOT aid cooperation!!

7
Suction

• Ask child/young persons consent
• 3-5 seconds only
• Only apply suction on withdrawal of suction
  catheter-from nasopharynx
• May need to do both nostrils requires suction
  catheter to be changed for every suction attempt

8
Equipment

• Hand washing facilities/alco-gel
• Suction machine in carry bag
• Suction tubing/connectors if required
• Suction catheters
• charger both mains transducer and car
• Gloves and aprons
• Disposal bag

9
What does a suction machine need?

• A working pressure gauge
• Intact jar
• Appropriate number of suction catheters
• 2 chargers-
• car charger
• Mains transducer and charging cable

• Suction tubing
• Connector with hole
• Current pak test number
• Carry bag
• Disposal bag
• hand gel

10
Typical suction machine
11
Checking the suction machine

• This is a very important part of the care you
  offer the child/young person
• Failure to check the machine correctly may mean
  you are putting the child/young person at risk
• You will be working out with your competency and
  will carry that responsibility Yourself!!

12
Prior to taking a child/young person out

• Check the charge levels by switching on the
  machine if battery low light on do NOT take the
  child young person with that machine
• Look at the machine and ensure all parts of the
  equipment are clean and intact
• Check both chargers and transducer are available

13
Suction Machine

• DO NOT take child out if suction machine shows
  red light this means the suction machine is not
  fully charged
• Always both car and mains chargers with you as
  well as transformer

14
Appropriate pressures

• Prem baby 80-100mmhg
• Baby to 1yr 80-100mmhg
• Toddler 100-120mmhg
• Preschooler 100-120mmhg
• School age 100-120mmhg
• Adolescent/adult 120-150mmhg

15
Checks

• Pressure is appropriate to child/young person
• Adequate supply of suction catheters
• Gloves

• Supply of cool boiled water for flushing of tube
• Disposal bags
• Hand cleaning gel
• Bag is safe to use

16
Catheter size

• This is usually decided by the hospital or physio
• There is a temptation to go further with a
  suction catheter than you will be competent to do
  
• Catheters come in different sizes and lengths- be
  aware of the size the child/young person you care
  for uses

17
Procedure

• This is a practical skill
• Please follow the procedure in the handouts
• Only cover the hole in the circuit while removing
  the catheter this completes the circuit and
  will then be the only time pressure is applied
• Complete the procedure as quickly as possible

18
Thank you for listening
Any questions
19
References

• Acornley J (2006) Policy for safe practice when
  providing oral suctionto children in the
  community Cambridgeshire PCT
• Beth Israel Deaconess Medical Centre Laboratory
  Manual care group Health \System internet
  Printed 14th May2006
• Huband Sand Trigg E (2000) Practices in
  Childrens Nursing Guidelines for Hospital and
  Community. Churchhill Livingstone, Edinburgh
• Moore T (2003) Suction techniques for the removal
  of respiratory secretions, Nursing Standard,
  18,9,47-53
• Coventry Teaching Primary Care Trust (Feb
  2006) - Hand hygiene Policy
• Coventry Teaching Primary Care Trust (Feb
  2006) - Clinical Waste Disposal Policy
• Coventry Teaching Primary Care Trust
  (2004) - Policy for Consent to
• 
  Examination and
  Treatment
• Essence of Care DoH 2001 Standards
  10- Record Keeping
  
• 
  Standard 11- Privacy and Dignity