What are 8 indications for airway suctioning?
What is suctioning?
Suctioning is a common procedure that is usually carried out to support patients with conditions, both temporary and permanent, that make it more difficult for them to clear secretions using more traditional methods (i.e., coughing). Suctioning can be performed on both natural and artificial airways such as endotracheal tubes or tracheostomies. [1]
Suctioning is performed using a suction catheter, a long and flexible tube that is inserted into the trachea. This tube should be appropriately sized for the patient and connected to a suction unit that will aspirate the secretions.
Are there any dangers associated with suctioning?
Although suctioning can be a lifesaving procedure, it is not without its risks. Suctioning is associated with a range of complications, including hypoxia, an irregular heartbeat and mechanical trauma to the lining of the airways. [2]
Suctioning should only be performed by a skilled healthcare professional. This requires knowledge of the respiratory system and an awareness on how to use the equipment carefully and appropriately. [3] They should also be aware of the potential complications resulting from the procedure and the most effective interventions for counteracting these side effects. [4]
Extra precautions and care should be taken while suctioning children, who generally have smaller and more fragile airways that are more susceptible to injury and other complications.
Suctioning should not be part of a long-term clinical routine and should only be undertaken when there are clear clinical indications requiring the procedure. [5] The frequency of suctioning will depend on the condition of the patient, which will be determined by an individualised assessment.
What are the main indications for airway suctioning?
| Indications for airway suctioning | Why is suctioning useful? |
|---|---|
| Abnormal breathing | Abnormal breathing is a sign of respiratory distress. Suctioning can help to open the patient’s airways and stabilise breathing patterns. |
| Altered mental state | Patients who are either comatose or taking sedatives and hypnotics may find their ability to clear secretions is compromised. Suctioning helps to clear these secretions and maintain the patency of the airways during periods of altered consciousness. [6] |
| Artificial airways | Patients with artificial airways may struggle to perform basic respiratory functions as easily as those without them. These functions include swallowing and coughing. Suctioning helps to remove secretions that may be occluding the artificial airways to ensure adequate oxygen flow to the lungs. [7] |
| Audible/visible secretions | Audible or visible secretions are two of the most obvious indications for airway suctioning. Both of these symptoms suggest a blockage in the airways. Suctioning will not only alleviate these symptoms, but also facilitate the passage of air to the lungs. |
| Endotracheal/tracheal cell sample | Suctioning is an effective method of collecting sputum and tracheal samples. These samples may be used for cell counts that may be used to prevent lower respiratory tract infections (LRTIs) that account for around 3 million deaths each year. [8] |
| Neuromuscular disorders | Neuromuscular disorders can lead to muscle weakness that makes it more difficult for patients to cough. Suctioning can facilitate the clearing of secretions and reduce the chances of developing lung infections. |
| Decreased oxygen saturation levels | A sudden reduction in oxygen saturation may be an indication that the airways are blocked in some capacity. Suctioning can help to clear any mucus or sputum that may be blocking the airways and enable oxygen saturation levels to return to normal. |
References:
- Sinha V, Semien G, Fitzgerald BM. Surgical Airway Suctioning. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448077/
- Ibid
- Pasrija D, Hall CA. Airway Suctioning. [Updated 2023 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557386/
- Ibid
- Ibid
- Sinha V, Semien G, Fitzgerald BM. Surgical Airway Suctioning. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448077
- Ibid
- Cartuliares, Mariana, et al. Expiratory Technique Versus Tracheal Suction to Obtain Good-Quality Sputum from Patients with Suspected Lower Respiratory Tract Infection: A Randomised Controlled Trial. Diagnostics 2022; 12 (10): 2504
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Please note that while every effort is made to ensure the accuracy of the content presented, it is purely for educational purposes only and is not a substitute for professional medical advice.