Overview of Surgical Airway Suctioning
Airway suctioning is a procedure doctors use to keep a patient’s airway clear. It involves removing mucus and other fluids to make sure the airway is open. This is especially important for patients who are on breathing machines, have tubes inserted into their windpipe, have an opening made in their neck to breathe, or have other tools aiding their breathing. Keeping the airway clear of mucus and fluids helps prevent lung infections, lung collapse, and ensures proper breathing. People on breathing machines or with tubes in their windpipe often produce more mucus because they are lying down, sedated, and the machines prevent natural clearing of mucus. Suctioning helps ensure the exchange of gases in the lungs, providing the body with enough oxygen, and supports normal breathing. Suctioning can be done through a breathing tube, a tube inserted in the neck, the mouth or the nose.
There are two ways to do suctioning: a closed system and an open system. Both methods follow the same basic steps, and precautions must be taken when performing the procedure. In closed suctioning, the suction is done within the existing breathing equipment.
The frequency of suctioning depends on the patient’s needs, which can be influenced by their age, health risk factors, and how easily their airway can be disrupted or lost. For example, research on newborns didn’t find higher risks with suctioning every 6 or 12 hours.
Anatomy and Physiology of Surgical Airway Suctioning
The suction method used is based on the specific area of the body that needs to be suctioned.
- For the area behind the nose (known as nasopharyngeal), the suction tube is inserted through the nostril and angled downwards towards the back of the nose.
- If suctioning is needed in the windpipe through a tube (Endotracheal suctioning), the suction tube is inserted into this breathing tube to the needed depth.
- If there’s a hole in the airway (Airway stoma), the catheter is inserted into this hole.
The airway is made up of two parts: the upper part, which includes the nose, the area behind the nose, the throat, and the voice box; and the lower part, which includes the windpipe, the large airways branching off the windpipe, the smaller airways branching off those, and the tiny air sacs in the lungs where oxygen is taken up.
When suctioning the airway in children, it’s important to be extra careful. Kids have smaller airways which are harder to access, and even small changes in pressure, oxygen levels, and lung size can have bigger effects on them.
Why do People Need Surgical Airway Suctioning
Patients who are connected to a breathing machine might need their airways to be suctioned or cleaned out. This is also necessary for those who are in a state of altered consciousness or are under the influence of sedatives or drugs that put them to sleep. People with diseases that affect their muscle function – leading to muscle weakness or reduced muscle tone – might also require suctioning. This procedure is beneficial for individuals who have a large amount of mucus or fluid in their lungs.
Infants and children who have lung diseases or difficulties breathing may also need this procedure. For medical investigations, suctioning can be used to collect samples from the windpipe or the breathing tube inserted into the windpipe. These samples could reveal the types of cells present and the different kinds of bacteria present. Lastly, the process can be used to monitor how efficiently a certain treatment is working by evaluating the difference in the condition of airways before and after treatment.
When a Person Should Avoid Surgical Airway Suctioning
There aren’t any solid reasons not to suction the airway, which is a process that helps patients breathe more easily. However, there can be risks with this process. The pros and cons should be thought over carefully for each patient’s unique situation. Extra caution should be taken if a patient has bradycardia (a slower than normal heart rate), hypoxia (lack of enough oxygen), or other similar health problems. The goal is always to ensure that the potential benefits of suctioning outweigh the possible risks for the patient’s well-being.
Equipment used for Surgical Airway Suctioning
Before starting the suction procedure, certain tools and supplies need to be set and ready to use. These include a source for oxygen and a source for vacuum. We also need sterile gloves, a stethoscope, a special adjustable device that helps regulate the oxygen, a bottle and tubing set for collecting fluids, and some kind of sterile water or normal saline to clean the area we’re working on.
For the safety of both the patient and the medical staff, personal protective equipment (PPE) should always be worn. This gear typically includes a gown, mask, and, ideally, protective eyewear. It’s also recommended to use sterile gloves. A special kind of sterile lubricant is used when suctioning through the nose.
Before we start, we should have monitoring devices ready to check oxygen levels in the blood (a device called SPO2), the amount of carbon dioxide at the end of a breath (end tidal CO2 monitors), and the heart and breathing rates (a cardiorespiratory monitor).
Finally, it’s crucial to use tubes or suction catheters of the right size to prevent any injuries or accidental dislodging or tearing. All these precautions help ensure the procedure is carried out smoothly and safely.
Who is needed to perform Surgical Airway Suctioning?
The people who perform airway suctioning, the procedure to clear your throat and lungs of fluid that may be blocking your airway, should be very knowledgeable about this process and its related equipment. They should be familiar with the structure of the airway, understand how to use the suctioning device, and know how to perform other respiration-related tasks. They should also be comfortable using a bag and mask to help you breathe if necessary. These skilled medical professionals are crucial in this process, as they can ensure the procedure goes smoothly and safely.
Preparing for Surgical Airway Suctioning
Before suctioning a patient’s airway, it’s crucial that medical personnel prepare carefully. This includes gathering all needed supplies and setting them up in a clean environment. In addition, they need to get the patient’s consent, whether verbally or in writing, based on the patient’s condition. The suction catheter, which is a thin tube that will help clear the airway, should be connected to a device that creates a vacuum effect.
The amount of preparation needed may vary depending on if the suctioning needs to be done urgently (emergently) or not (non-emergently). If a patient is having severe breathing problems and it’s suspected that there is a blockage in their airway, then suctioning should be done straight away, even if only minimal preparations have been made. It’s important, though, that the process is kept as sterile as possible, especially when suctioning tubes in the windpipe (endotracheal) or an artificial opening in the windpipe (tracheostomy). On the other hand, suctioning the back of the throat (oropharynx) or behind the nose (nasopharynx) doesn’t require the process to be completely sterile.
When suctioning isn’t urgent, it’s essential to properly prepare all equipment and staff involved. This helps to make sure that the procedure is safe, effective and minimizes the risk of spreading infections.
How is Surgical Airway Suctioning performed
Suctioning the airway is a process which must only begin once all the necessary supplies and personnel are ready, and the patient has given consent. Essentially, airway suctioning is a medical procedure where we clean out your airways to make it easier for you to breathe. Before we start, we will give you high levels of oxygen to ensure you have enough, as the process of suctioning may briefly interrupt the normal flow of oxygen. If we are going to suction through the nose, we use petroleum jelly to make the catheter (a thin tube used to perform the procedure) slide easily.
When we start the procedure, we’ll slowly insert the catheter through the nose and mouth. If we meet resistance, we’ll stop and give you more oxygen before we try again. This catheter goes to a depth we determine is necessary to clear your airways and then we start suctioning, meaning we start the process of clearing out your airways. We limit this process to about 10 seconds each time to avoid damage to the inside of your nose and mouth and make sure you’re getting enough oxygen.
As we pull out the catheter, we’ll do it slowly and turn it gently to avoid discomfort. In case you need this procedure more than once, we will check your vital signs such as heart rate and oxygen levels to make sure you’re doing well, and we’ll make necessary adjustments in between each session.
We can perform this suctioning in two ways: we can either directly suction through a tube placed in your windpipe (open suction), or we can do it through a specialized system without removing respiratory support (closed suction). There’s a debate in the medical community about whether to use a normal salt solution during suctioning. Some studies suggest it might cause low oxygen levels and slow heart rates, so we generally avoid this approach.
In some rare cases, we might need to give you medication to relax or reduce pain before suctioning. After the suctioning, we’ll know it was successful if we cleared out secretions from your airway, your breathing sounds better, you have good oxygen levels, and you’re less distressed.
Possible Complications of Surgical Airway Suctioning
If performed carefully and with enough oxygen supply, complications from airway suctioning, a procedure to clear the air passage, are relatively rare. However, this process may lead to issues in some cases. For example, the suctioning can stimulate something called the vagal nerve causing a slow heart rate (bradycardia) and low oxygen level in the body (hypoxia). A major drop in oxygen can result from blockage, discontinuation of oxygen supply, or prolonged suctioning.
Suctioning can also cause injuries to the mucosal lining of the airway, which is the soft moist tissue lining the inside of the airway. These injuries could result in physical harm or bleeding, particularly if the procedure causes blunt or penetrating trauma. Additionally, suctioning could introduce organisms that usually live harmlessly on the body, known as commensals, into the respiratory tract, potentially causing infections.
It’s also worth noting that the procedure can cause discomfort and could be associated with feelings of anxiety in people. Nevertheless, rest assured that health care professionals undertake suctioning with utmost care to prevent any of these potential issues.
What Else Should I Know About Surgical Airway Suctioning?
Suctioning is a procedure that can save lives. It’s important to perform it correctly and precisely, as this can lower the chances of infection, fluid buildup, and lengthy periods of low oxygen.
This procedure involves clearing the airways and should be done by trained professionals who know what they’re doing. Apart from offering health benefits, suctioning can also help diagnose certain conditions. It’s important to be familiar with the equipment and to understand how the airways and any aids being used, work.
When suctioning the airway, it’s important to be careful to avoid causing injuries, bleeding, or prolonged periods of low oxygen. It can also lead to a slow heart rate. Being prepared is really important, and the person doing the suctioning should know what problems could come up and how to fix them. All the necessary medical equipment and medication should be on hand before starting the procedure. This will help ensure the airway stays open, which is vital for successful suctioning.
