This one has always confused me, even though it is a fundamental topic. One of my nursing instructors gave a lecture on ensuring bedside suction is always set up during your initial visit and safety inspection of patients' rooms. In this lecture I could have sworn she meant ALL PATIENTS should have working bedside suction. However suction is rarely ever correctly set up and working in most patient rooms I visit on the med-surg floor. Many of the floor nurses do not check to see if it is set up and working until they need it.
I can't find any articles or educational resources supporting that all patients should have suction set up. Obviously suction should be set up and working for patients with a trach, seizure precautions, NG tubes ect.
Please give me your feedback. Why or why not suction should be set up at bedside for all patients? If you have any links that discuss your rational please post them too. Thanks for clarifying.
I wish we had it at every bedside. We do not and it is very difficult to find a functioning suction regulator even when NOT in a hurry. There is a regulator in the crash cart but during a recent code where suction was needed, they found out that the wall suction was not working so the regulator and accompanying suction set up was rendered useless. There was no battery operated suction on the crash cart. If each room had suction all the time and it was checked each shift, this could have been avoided. I wish they would zip tie the suction, air and O2 regulators to the wall. Sometimes I'll have to walk around for 10 mins. looking for one. In a code that would be critical time wasted which could easily result in a poor outcome for the pt.
It's on the wall everywhere I have worked. Actually X2 because I work L&D and we have one above mom's bed and above the warmer for the baby. I check them every time..especially the baby one.
One of the best habits you can get in to is checking your rooms to ensure that everything is in working order BEFORE you may need it. Including a suction set up. (and your O2 set up). Nothing goes south faster than when something happens to the patient and you need to use things that are not working correctly.
Yes, there are some items that are on the code cart that should also be checked and used--however, if the items are right there, just check them. And if they do not work, fix them so they do.
In your response to the question about someone choking on food etc. You would follow the Heimlic manuever and basic CPR. Usually a yankauer is for secretions in the oral cavity only. To get something from the trachea you would have to use a suction catheter and do NT type suction(naso-tracheal). You need to supply 100% oxygen when doing NT suctioning, so have Oxygen readily available when performing this manuever. Check your Nursing Policy and Procedure manual. Yes, having wall suction is a priviledge, the building I worked sub-acute in was built in the late 60's and did not have wall suction. I really missed it!!! The gomco machines can be very tricky in that the suction pressure is not always enough to really get thick secretions, check your machines before you really need to use them. If your patient is unconscious you can use an oral airway to assit you in keeping the tongue from blocking the airway, you need to know how to insert these and there are different sizes for the various sizes of airways, usually small. Med, and Large. You most likely could get some training at a local AHA for insertion of oral airways. Good Luck!!
I'd being willing to bet that patient didn't actually die due to lack of suction.
Ofcourse a suction would not have saved his life and I never said it would have. However, it should have been there period. We should not have been fumbling with connecting the suction while he needed his airway cleared.
We have suction in every room. The suction canisters are attached to the wall, the tubing is attached to the canister, the yankauer is left in the package, and everything is wrapped in a plastic bag. To use, one just opens the bag, opens the yankauer package, connect and go. Having done it in a hurry, it really isn't that challenging.
That being said, even with suction in every room, apparently that's not enough, as a nurse came on to the unit a few days ago asking urgently for portable suction. I was non-plussed. We have suction on the walls...what exactly did she want?
Turns out she had a pt on the toilet that was in need of suction. I grabbed some extra tubing, bumped up the suction strength, and voila.
We do not have portable suction on our code cart, which I think is unreasonable. The cart goes to places we don't have suction, like public restrooms and lobbies in the hospital.
Specializes in ORTHO, TRAUMA, MED-SURG, L&D, POSTPARTUM.
It is part of our daily safety checks, code sheet, wall suction, oxygen, and med air, ambu bag, set up for every patient
I agree. I feel like it should be just a routine all nurses do for the whole floor, but since it isn't it means only the nurses that care about having it set up have to hook it up for every patient they have. Kind of annoying and not ideal for hectic mornings when you hit the floor running. Better safe then sorry.
Specializes in ORTHO, TRAUMA, MED-SURG, L&D, POSTPARTUM.
In your response to the question about someone choking on food etc. You would follow the Heimlic manuever and basic CPR. Usually a yankauer is for secretions in the oral cavity only. To get something from the trachea you would have to use a suction catheter and do NT type suction(naso-tracheal). You need to supply 100% oxygen when doing NT suctioning, so have Oxygen readily available when performing this manuever. Check your Nursing Policy and Procedure manual. Yes, having wall suction is a priviledge, the building I worked sub-acute in was built in the late 60's and did not have wall suction. I really missed it!!! The gomco machines can be very tricky in that the suction pressure is not always enough to really get thick secretions, check your machines before you really need to use them. If your patient is unconscious you can use an oral airway to assit you in keeping the tongue from blocking the airway, you need to know how to insert these and there are different sizes for the various sizes of airways, usually small. Med, and Large. You most likely could get some training at a local AHA for insertion of oral airways. Good Luck!!
Thanks for the informative post. I will have to look into seeing if AHA has any courses that train for insertion of oral airways. Always looking for hands on education! :)
On my med/surg floor we do have wall suction, however we dont have enough regulators for all of the patients. So, suction is not set up unless they have a need (trach, tube feed, excessive secretions etc). I wish it was not like that as I think the standard should be that all pts have suction and oxygen. Not all of my patients even have oxygen set up (those darn christmas trees always disappear!!!)
The code cart has a portable suction if needed. I work in a large, teaching facility so I am quite surprised that we dont have enough resources for every patient to have standard setup. ):
annie.rn
546 Posts
I wish we had it at every bedside. We do not and it is very difficult to find a functioning suction regulator even when NOT in a hurry. There is a regulator in the crash cart but during a recent code where suction was needed, they found out that the wall suction was not working so the regulator and accompanying suction set up was rendered useless. There was no battery operated suction on the crash cart. If each room had suction all the time and it was checked each shift, this could have been avoided. I wish they would zip tie the suction, air and O2 regulators to the wall. Sometimes I'll have to walk around for 10 mins. looking for one. In a code that would be critical time wasted which could easily result in a poor outcome for the pt.