The Core Components of Oronasal Suctioning
At the heart of oronasal suctioning is the core suctioning system, which consists of several vital parts that work together to remove secretions from the airway. Understanding each component is the first step toward proper and safe operation.
Suction Machine
The suction machine, or aspirator, provides the negative pressure required to draw secretions from the patient's airway. There are two main types:
- Wall-mounted suction: Found primarily in hospital and clinical settings, these units are highly reliable and offer a consistent vacuum source.
- Portable suction machine: Ideal for home care, emergency transport, or patients who require mobility, these battery-operated or rechargeable units provide flexibility without compromising on effectiveness.
Connecting Tubing
This is the flexible plastic tubing that connects the suction machine to the collection canister and the patient's catheter. It must be clear to allow the caregiver to monitor the flow and nature of the secretions being removed. Regular inspection for kinks, leaks, or blockages is crucial for maintaining effective suction.
Collection Canister
The collection canister is a disposable or reusable container that safely holds the secretions and fluids removed from the patient. It features an overflow protection mechanism to prevent fluids from entering and damaging the suction machine. After use, the canister is emptied and cleaned or disposed of according to protocol.
Catheters for Specific Suctioning Needs
The type of catheter used is determined by whether the suctioning is primarily oral or nasal. Using the correct catheter minimizes trauma and maximizes efficiency.
Yankauer Suction Tip (Oral Suctioning)
For oropharyngeal suctioning, a rigid, plastic Yankauer tip is the standard. Its bulbous head and multiple large openings are designed to efficiently remove thick, copious secretions from the mouth and back of the throat while preventing tissue trauma.
Flexible Suction Catheters (Nasal Suctioning)
Nasopharyngeal suctioning requires a flexible, soft catheter that is inserted gently through the nose to access the pharynx and upper trachea. These catheters come in various sizes, or French (Fr) sizes, to accommodate different patient ages and needs. A smaller French size is used for pediatric patients, while a larger size is more appropriate for adults.
Essential Ancillary Supplies
Beyond the core system, a number of additional items are necessary for a safe and sterile procedure. These supplies are crucial for infection control, patient comfort, and procedural effectiveness.
Personal Protective Equipment (PPE)
Because suctioning can generate splashing, full PPE is required to protect both the caregiver and the patient. This includes:
- Non-sterile and sterile gloves: Non-sterile gloves are used for setup, while sterile gloves are often required for sterile suctioning procedures to prevent infection.
- Face shield or mask and goggles: Protects the eyes, nose, and mouth from infectious splashback.
Saline or Water
Tap water or normal saline is used for flushing the catheter and connecting tubing to prevent clogging between suctioning attempts. A disposable cup or basin is needed to hold the flushing solution during the procedure.
Lubricant
A water-soluble lubricant is essential for nasopharyngeal suctioning to ease the insertion of the flexible catheter into the nasal passage and minimize discomfort.
Other Supportive Items
- Towel or drape: Placed over the patient's chest to protect their clothing and bedding from secretions.
- Pulse oximeter: Monitors the patient's oxygen saturation, providing an important indicator of their respiratory status during the procedure.
Comparison of Oral vs. Nasal Suctioning Equipment
| Feature | Oral (Oropharyngeal) Suctioning | Nasal (Nasopharyngeal) Suctioning |
|---|---|---|
| Catheter Type | Rigid, firm plastic Yankauer tip | Flexible, soft plastic catheter |
| Insertion Path | Through the mouth, along the gumline to the pharynx | Gently through the nares, along the floor of the nostril |
| Lubricant | Not typically required | Water-soluble lubricant is essential for insertion |
| Sterility | Often uses clean technique in non-sterile environments | Sterile technique required in many clinical settings |
| Target Secretions | Thick, copious secretions from the mouth/throat | Thinner, deeper secretions from the nasopharynx |
| Risk of Gag Reflex | Higher due to stimulation of the back of the throat | Lower, though gagging can still occur |
Proper Setup and Maintenance
Pre-procedure Steps
- Hand hygiene: Always wash hands thoroughly before and after the procedure.
- Assemble supplies: Gather all necessary equipment and place it within easy reach on a clean surface.
- Check the suction unit: Turn on the machine and occlude the tubing to verify that adequate suction pressure is being generated.
- Position the patient: A semi-Fowler's position is standard for conscious patients, while a lateral position is used for unconscious patients to prevent aspiration.
Equipment Maintenance
Regular maintenance is crucial for the longevity and safety of the equipment. Filters should be checked and replaced regularly, and the canister and tubing must be cleaned or disposed of according to manufacturer guidelines and infection control protocols.
Conclusion
Effective oronasal suctioning relies on a comprehensive set of equipment, including the suction machine, connecting tubing, collection canister, and specific catheters for oral and nasal use. Ancillary supplies like PPE, saline, and lubricant are equally important for a safe procedure. By assembling the correct tools and following proper technique, caregivers can efficiently clear airways and promote better respiratory health for those in need. For more detailed clinical guidelines and procedures, consult authoritative sources such as those found on the National Center for Biotechnology Information (NCBI) website.
