Suctioning techniques for the removal of respiratory secretions

Abstract

Suctioning techniques are a necessary nursing intervention to remove respiratory secretions and maintain optimum ventilation and oxygenation in patients who are unable to get rid of these secretions independently. This intervention can induce problems and it is important that the correct procedure is adhered to so that patient safety and comfort are maintained. Nurses should be competent in assessing the need for suction. The decision to perform this procedure should be based on the patient's clinical signs and symptoms and should not be undertaken as a matter of routine.

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

“…These articles varied in their description of respiratory assessment. Fifteen of the articles reviewed identified auscultation of the chest or changes in ventilation airway specific clinical assessment parameters (Ahrens & Sona, 2003;Baun,1984;Blackwood,1999;Chang, 1995;Curley & Thompson, 1995;Hodge, 1991;Day, Wainwright & Wilson-Barnett, 2001;Day, Farnell, Haynes, Wainwright & Wilson, 2002;Gilbert, 1999;Moore, 2003;Place & Fell, 1998;Tolles & Stone, 1990;Dougherty-Wrightson and Askin, 1999;Wainwright & Gould, 1996;Wood, 1998). Knox (1992), Place andFell (1998), Dougherty-Wrightson andAskin (1999) and Gilbert (1999) expanded on the process of respiratory assessment to include signs of respiratory distress and diminished breath sounds.…”

“…Compounding these issues was inadequate knowledge of protocols and practices that directly impact on the quality of patient care (Blackwood, 1999;Day, Farnell, Haynes, Wainwright & Wilson-Barnett, 2002;Day, Wainwright & Wilson-Barnett, 2001;Cousins & Power, 1999;Jacobe, Denessen & Postma, 2004;Lester & Tritter, 2001;Mangione & Neiman, 1997;McGlynn & Brook, 2003;Moore, 2003). To address these issues, strategies such as continuing education, evidence based practice, use of assessment tools and maintenance of clinical support in the PIC arena have been shown to improve both patient care and outcome (McGlynn & Brook, 2003;Moore, 2003). These issues together with the potential complications associated with endotracheal suction add further support to the development of an evidence based Endotracheal Suction Assessment Tool.…”

“…Initially there was broad reference to "clinical indicators" relating to the patient"s respiratory status that would require initiating suction of the endotracheal tube (Baun, 1984;Chang, 1995;Copnell & Fergusson, 1995;Dougherty-Wrightson & Askin, 1999;Gilbert, 1999;Hodge, 1991;Knox, 1992;Moore, 2003;Place & Fell, 1998;Runton, 1992;Swartz, Noonan & Edward-Beckett, 1996;Wood, 1998). Further in-depth analysis showed these "clinical indicators" included "visible or audible secretions" in the endotracheal tube which contributed to the respiratory assessment process and are attributed to the "physical signs" identified in the initial review of the literature (Dougherty-Wrightson & Askin, 1999;Baun, 1984;Carhuapoma & Williams, 1999;Copnell & Fergusson, 1995;Day, Wainwright & Wilson-Barnett, 2001;Dyhr, Bonde & Larsson, 2003;Gilbert, 1999;Moore, 2003;Place & Fell, 1998;Runton, 1992;Swartz, Noonan & Edward-Beckett, 1996;Wood, 1998).…”

“…Further in-depth analysis showed these "clinical indicators" included "visible or audible secretions" in the endotracheal tube which contributed to the respiratory assessment process and are attributed to the "physical signs" identified in the initial review of the literature (Dougherty-Wrightson & Askin, 1999;Baun, 1984;Carhuapoma & Williams, 1999;Copnell & Fergusson, 1995;Day, Wainwright & Wilson-Barnett, 2001;Dyhr, Bonde & Larsson, 2003;Gilbert, 1999;Moore, 2003;Place & Fell, 1998;Runton, 1992;Swartz, Noonan & Edward-Beckett, 1996;Wood, 1998).…”

“…Some authors referred to "patient assessment", however, the focus was in fact involving respiratory assessment by observing for changes in oxygen saturations not attributed to any other clinical cause or auscultation of the lung fields where changes in "air entry and audible secretions" would indicate the need for endotracheal suction to occur (Baun, 1984;Chang, 1995;Copnell & Fergusson, 1995;Day, Wainwright & Wilson-Barnett, 2001;Dougherty-Wrightson & Askin, 1999;Gilbert, 1999;Hodge, 1991;Knox, 1992;Moore, 2003;Place & Fell, 1998;Runton, 1992;Swartz, Noonan & Edward-Beckett, 1996;Wood, 1998).…”