Airway Suctioning

A coarse airway sound, visible mucus in an artificial airway, or a saw-tooth ventilator waveform can indicate retained secretions. Suctioning removes secretions, but it can also cause oxygen desaturation, bleeding, hemodynamic change, altered heart rate, and airway-mucosal injury. It is therefore an assessment-driven intervention, not a routine response to the presence of an airway tube alone. Before proceeding, confirm that suctioning is indicated, equipment and oxygen are ready, and the intervention is authorized for the nurse's role and setting. In Ontario, RNs and RPNs may perform authorized controlled acts with an order or may initiate specified acts only when the regulation and practice setting permit it; nurses may not initiate controlled acts in a public hospital, so an order is required there. In British Columbia, an LPN provides tracheostomy care, including suctioning through the tracheostomy, only under a client-specific order, only for a client with a well-established tracheostomy, and only after successfully completing additional education; suctioning the nasal passages beyond the point where they normally narrow also requires a client-specific order and additional education. Suctioning through an endotracheal tube is...