Newborn Suctioning

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Principles:

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PROCEDURE RATIONALE

NO

T PR

EFO

RMED

UN

SATI

SFAC

TORY

SATI

SFAC

TORY

GO

OD

VERY

GO

OD

EXCE

LLEN

T

1. Perform Hand washing 0 1 2 3 4 5 6 7 8 92. Assess the infant to determine the need for suctioning.

PREPARE THE EQUIPMENTa. Complete equipment check and assemble any

additional supplies required.b. Attach catheter to suction sourcec. Check suction pressure. Maximum negative pressure

should not exceed 100 mm Hg with the tube occluded.

Use m to avoid trauma, laryngospasm, and bradycardia minimal negative pressure.

60 to 100 mm Hg for infants And 40 to 60 mm Hg for premature infants

Equipments:

Towels or pads Emesis basin lined with

paper Portable or wall suction

machine: includes a collection bottle, a tubing system connected to the suction catheter, and a gauge that registers the degree of suction

Sterile disposable container for sterile fluids

Sterile normal saline or water

Sterile gloves Sterile suction catheter

For infants - # 5 to # 8

Water-soluble lubricant or glass of sterile water

Y-connector Sterile gauzes Moisture-resistant

disposable bag Sterile forceps (in cases

where institution practices such or in absence of gloves)

d. Set the pressure on the suction gauge and turn on the suction.

Wall unit Infant: 50-95 mmHg Portable unit Infant: 2-5 mmHg

3. Open the sterile suction package.4. Set up the cup or container, touching only its outside.

5. Pour sterile water or saline into the sterile container.6. Don the sterile gloves, or don a nonsterile glove on the

non-dominant hand and sterile glove on the dominant hand.

7. With you sterile gloved hand, pick up the catheter, and attach it to the suction unit.

8. Open the lubricant if performing nasopharyngeal suctioning.

9. Make an approximate measure of the depth for the insertion of the catheter and test the equipment.For oropharyngeal and nasopharyngeal suctioning:

Measure the distance between the tip of the client’s nose and the earlobe or appropriate distance for an infant or small child is 4 to 8 cm (1.6 to 3.2 in) or 8 to 12 cm (3.2 to 4.8 in) for an older child.

For nasal tracheal suctioning, measure the distance from the mouth to earlobe and then to halfway down the neck

For oral tracheal suctioning, measure from the mouth to the midsternum.

7. Mark the position on the tube with the fingers of the sterile gloved hand.

Lubricate and introduce the catheter.8. For nasopharyngeal suction:

a. Lubricate the catheter tip with water-soluble lubricant.

b. Without applying suction, insert the catheter the premeasured or recommended distance into either nares, and advance it along the floor of the nasal cavity.

c. Never force the catheter against an obstruction. If one nostril is obstructed, try the other.

9. For an orpharyngeal suction:a. Moisten tip with sterile water or saline.

b. Pull the tongue forward, if necessary, using gauze.

c. Do not apply suction during insertion.

d. Gently advance the catheter along one side of the mouth into the oropharynx.

Perform suctioning.10. Hyperoxygenate the infant before suctioning.11. Apply suction for 5 seconds; then remove your

finger form the control, and remove the catheter. A suction attempt should last only 5 seconds. During this time, the catheter is inserted, the suction applied and discontinued, and the catheter removed. It may be necessary during oropharyngeal suctioning to apply suction to secretions that collect in the vestibule of the mouth and beneath the tongue.

Rinse the suction catheter with normal saline between each insertion

Nasal Suctioning: The catheter must remain upright at the nose.

Clean the catheter, and repeat suctioning as above.12. Wipe off the catheter with sterile gauze if it is thickly

coated with secretions. Dispose of the gauze in a moisture-resistant bag.

13. Flush the catheter with sterile water or saline.

14. Relubricate the catheter, and repeat suctioning until the air passage is clear.Note: Allow 20- to 30-second intervals between each suction, and limit suction to 5 minutes in total.

15. Alternate nares for repeat suctioning.

16. Discard suction tube, other equipment and gloves in appropriate containers

17. Wash hands.18. Document relevant data

FEEDBACK/COMMENTS:

FACULTY SIGNATURE: ___________________________________________

References (s):

1. Foundations of Maternal – Newborn Nursing 4th Edition (2007) Saunders Elsevier by Sharon Smith Murray and Emily Slone McKinney2. Wong’s Essentials of Pediatric Nursing 7th Edition ( 2005) Elsevier by Marilyn J. Hockenberry, David Wilson and Marilyn L. Winkelstein3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2145775/pdf/canfamphys00126-0063.pdf