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Aspiration of oropharyngeal and nasopharyngeal secretions


Removal of secretions from the airways, when the patient is unable to expel them on his own, by introducing an aspiration catheter into the patient’s oral and tracheal airway.

Objectives:

– To maintain the patency of the patient’s airway. – To achieve the elimination of secretions obstructing the airway to facilitate respiratory ventilation. – To prevent respiratory infections as a consequence of the accumulation of secretions. – Facilitate the collection of specimens.

Equipment:

– Vacuum aspirator. – Tray. – Oxygen intake. – Flow meter. – Vacuum gauge. – Connector tube. -Phonendoscope. – Manual resuscitator with reservoir.

Material:

– Sterile suction probes of the appropriate number. – Container for secretions. – Sterile gloves. – Sterile gauze. – Mask. – Washing solution: sterile water or sterile saline solution. – Soaker. – Disposable gowns. – Waste bag. – Disposable paper towelettes. – Oxygen mask. – Sterile lubricant. – Nursing records.

Procedure:

– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Inform the patient of the procedure to follow. – Ask the patient and family to cooperate. – Connect the aspirator and the suction equipment. Check its correct functioning. – Choose the appropriate probe size. The diameter should be equal to half of the airway (adults: 12-18 F; children: 6-12 F and infants 5-6 F). – Select the appropriate pressure on the vacuum gauge: adults 115-150 mmHg, children 95-115 mmHg and infants 50-95 mmHg. – Place the patient in the semi-fowler position. If the suction is to be performed orally, place the patient with the head tilted; if nasal, place the patient’s neck in hyperextension; if the patient is unconscious, place the patient in lateral decubitus. – Place a soaker covering the pillow or under the patient’s chin. – Pre-oxygenate the patient if necessary (follow general rules for oxygen therapy management). – Put on a mask, sterile gloves and disposable gown. – Measure the distance to be introduced, between the bridge of the nose and the earlobe (approximately 1.5 m). – Lubricate the probe in the nasopharyngeal aspiration. – In case of dry secretions and mucous plugs, instill physiological saline 0.9% and hyperinflate before the aspiration procedure. – Introduce the tube without aspiration through the mouth or nose and perform intermittent aspiration when removing the tube. This maneuver should not exceed 10 seconds. – In oropharyngeal aspiration, insert the tube in the side of the oropharynx. – Clean the probe with sterile gauze and aspirate sterile saline or water. – Repeat the aspirations as many times as necessary. – Discard the probe and gloves after aspiration. – Let the patient rest between aspiration and aspiration. – Encourage the patient to take deep breaths and perform the assisted coughing procedure. – Place the patient in the most appropriate position. – Collect the material. – Remove gloves and mask. – Perform hand washing. – Record in the nursing documentation: procedure, reason, date and time, incidences, characteristics of secretions, and patient response.

Observations:

– Sterile technique. – Avoid aspiration of secretions after meals. – Use a new tube each time the aspiration maneuver is performed. – Observe for signs of respiratory or cardiac distress. – Leave spare equipment after each aspiration. – Short-term or immediate complications that may arise are: bronchospasm, hypoxemia, bradycardia, tracheal and bronchial trauma, anxiety, hypertension, hypertension, and increased intracranial pressure. In the long term, respiratory infection may occur.

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