TEACHING SHEET ON: SUCTIONING THE NOSE AMD MOUTH

 

The patient needs help to keep the mouth and nose clear of mucus.
Suctioning equipment, a humidifier, and other supplies will be
needed. While the patient la in the hospital, you should use the
same suction machine that you will be using at home. Th1a allows
you a chance to become familiar with the equipment. You will allow
need a mucus trap or nasal aspirator that can be used to remove
mucus when you and the patient are away from home. Practice with
these items while the patient is in the hospital.
Certain guidelines are helpful for the patient who has problems
clearing mucus from the back of the nose and mouth (pharynx) . To
keep the mucus liquid so that it is easy to remove by both
suctioning and coughing, added moisture is needed. Encourage the
patient to drink at least 1 quart (four 8-ounce cups) of liquid a day
and place a cool mist humidifier in the room where the patient
sleeps. Change the water in the humidifier each day and clean the
humidifier regularly, according to the manufacturer's instructions.
All of the people who provide care for the patient must know how to
suction the patient so that they can assist you. Tape the emergency
phone numbers, such as 911 (if available in your area), the local
hospital, your health professional, and any numbers that are
necessary, to each telephone in the house. Notify your health
professional if any of the following occur:
  • -Temperature above 102
  • —Presence of yellow or green mucus
  • -Change in the smell of the mucus
  • -Increased amount of mucus
  • -If the patient is very irritable
  • -If the patient is having difficulty breathing call 911

SUCTIONING:
Suctioning keeps the airway (nose and mouth) (Fig. I) clear of
mucus to help the patient breathe more easily. Suctioning is not
done routinely, but only when needed. Suction when the following
occur:
  • -The patient is having trouble breathing
  • -The patient appears very restless
  • -The patient has difficulty eating or sucking
  • -The patient's color becomes paler
  • -The patient's nostrils flare (spread out)
  • -You will hear the sound of air bubbling through the mucus.

When the patient has a cold, more mucus is produced, so you mill probably need to suction more often. The patient may cough or gag when you insert or remove the suction catheter Gently tell the patient when you are almost finished. , If the patient is old enough, teach him how to help you by holding the supplies.

Equipment:
  • Suction machine with tubing
  • Suction catheters
  • Sterile water
  • Clean container for rinsing catheter
  • Gloves

Instructions:
1.   Gather all the equipment you will need.
2.   Wash your hands with soap and water.  Count to 10 while
washing, then rinse with clear water and dry with a clean
paper or cloth towel. Wear gloves.
3.   Open the suction catheter package and connect the catheter
to the suction machine.
4.   Make sure the suction machine is plugged in and working.
5.   Measure the tube for the distance you will have to insert
it.  Place the tip of the catheter at the patient's ear lobe
and mark the distance to the tip of the patient1 s nose. Hold
the catheter at this mark
6.   Place the tip of the catheter in the sterile saline
and place your thumb over the opening to obtain suction.
The saline wets the catheter (Fig. 3).
7.   Tell the patient to take a deep breath.
8.   With your thumb off the opening (no suction), insert
the suction catheter in one nostril up to the measured
distance (Fig. 4,A).
9.    Place your thumb on the suction port to obtain
suction.
10.  Rotate or twist the catheter as you remove it with a
slow steady motion (Fig. 4B), Both inserting the catheter
and suctioning should take no longer than 4 seconds.
Remember, the patient may not breathe while you are
suctioning. Try holding your breath whenever your thumb is
on the suction port.  This will be a reminder to you for
timing.
11.  Look at the mucus. Check the color, smell, and
consistency for any change.
12.  Rinse the suction catheter in the sterile saline with
your thumb on the suction port.
13.  Allow the patient to take a few deep breaths.
14.  Repeat steps 7 through 14 up to 2 times if needed (for
large amounts of mucus), then repeat for the other nostril.
15.  After suctioning the nose, you can use the same
catheter to clear the patient's mouth.
16.  Place the tip of the catheter in the saline and place
your thumb over the opening to obtain suction.
17.  Tell the patient to take a deep breath.
18.  With your thumb off the opening (no suction), insert
the suction catheter in the patient's mouth along one side of
the mouth until it reaches the back of the throat.
19.  Place your thumb on the suction port to obtain
suction.
20.  Rotate or twist the catheter as you 'remove it with a
slow steady motion.  Both inserting the catheter and
suctioning should take no longer than 5 seconds. Remember,
the patient may not breathe while you are suctioning. Try
holding your breath whenever your thumb is on the suction
port. This will be a reminder to you for timing.
21.  Look at the mucus. Check the color, smell and
consistency for any change.
22.  Rinse the suction catheter in the saline with your
thumb on the suction port.
23.  Allow the patient a chance to take a few deep breaths.
24.  Repeat steps 17 through 2 3 up to three times.
25.  Hold and comfort the patient.
26. After each use, throw away the saline and clean the container. The suction machine should be clean and ready for the next
tine that you will have to use it.
27. Your health professional will Instruct you on the care of
the suction catheters or use the method described below.
28. Wash your hands with soap and water.  Count to 20 while
washing your hands, then rinse with clear water and dry
with a clean paper or cloth towel.


INSTRUCTIONS FOR CLEANING THE SUCTION CATHETERS
1.   Rinse the suction catheters in cool tap water. Do not use
hot water because it "cooks" the mucus, which makes it more
difficult to remove.
2.   Place the catheters in a clean jar filled with hot, soapy
water.
3.   Rinse both the inside and outside of the tube under hot
running water. Hold the tube with kitchen tongs so that
you don't burn yourself.
4.   Shake off the excess water.
5.   Place on a clean paper towel to dry. When tube is completely
dry, place it in a clean plastic bag.
6.   Close the bag and store until the next time you suction the
patient.
7.   If you notice any moisture in the bag, repeat the entire cleaning procedure.