Question

TOPIC: Endotracheal and Tracheostomy Suctioning ; Tracheostomy Care

Make a table and indicate ‘When To Perform Suction and in Whom’, then the other column would include ‘When NOT To Perform Suction.’

Example:

When to Perform Suction in Whom When NOT to Perform Suction

Answer 1

Answer:

Tracheostomy means the process of making incision through the neck into the trachea which opens airway and helps in the breathing.Tracheostomy suctioning means it removes the thick mucus and secretions from the Trachea and lower airway when patient is not able to clear tbeir throats by coughing.

--Suctioning may be done through different equipment  like Endotracheal tube, Tracheostomy tube, or through the nose or mouth inti trachea to maintain airway.

S.NO	WHEN TO PERFORM SUCTION	IN WHOM	WHEN NOT TO PERFORM SUCTION
1.	Before meals	in patients with Obstruction of the mouth or throat	if patient is not pre oxygenated then risk of Hypoxia is high then remove the suction tube.
2	Suction should be done to patients when they wake up in morning and before go to bed in evening.	Breathing difficulty is caused by Edema (swelling), injury or pulmonary (Lung) condition problems.	Do not perform suction while inserting Catheter.This causes increases the chance of injuring the Mucous membrane.
3	in some patietns, mucus plugs or increased sputum production may cause decrease in Oxygen levels and then Suctioning should be done.	in patients who have Tracheal or Laryngeal surgery	Suctioning limit should not increase the 10 seconds.
4	when sputum sample is required but patient is unable to cough to provide enough sample then Suctioning helps to obtain sample.	Due to swallowing problem in patients have airway protection from secretions or food.	if patient develop cardiovaascular changes like cardiac arrythmia then suction is risk
5	Visible or audible secretions in the airway	In patients who have head or neck surgery they need airway protection and need suctioning	if infection developed due to suction then immediatly stop suction
6	Oxygen desaturation and restlessness of patient thene suctioning should be done.	in patient who need long term ventilator support	if patient feels discomfort and injury to the Tracheal mucosa then suction is risk.
7	signs of Respiratory distress like increased Respiratory rate, Tachycardia, gasping, difficulty breathing then suctioning should be done.	in Respiratory failure patients due to cardiac or respiratoy diseases	Endotracheal suction should not perform routinely but only when mucus secretions are present.
8	Suspected Airway obstruction in patinet suctioning should be done	defects in Neuromuscular system that controls breathing , injury to chest patients	installation of normal saline before the Endotracheal suction should not be performed routinely.
9	suctioning must be done to Intubated patient when high resistance,less SPO2, more PEEP and also high Fio2 signs shows.	Artificial breathing patients needs suctioning while being on ventilator.	not intubated patients if shows Coarse breath sounds then suctioning shoud be done after the patient coughs.
10	Endotracheal suctioning should be done when patient shows Sawtooth pattern on flow volume loop on ventilator monitor.	Acute respiratory distress	complictions like Atelectasis and hemorrage then suctioning is risk.
11	before going to outdoors
12	before going to sleep.