Suction

WalkieTalkie, RN · Sep 13, 2009

Hello everyone! Is a Doctor's order needed for suction?

Depends on what you're suctioning... is a trach or ETT in place... or are you referring to some other type of suctioning?

jenniferhope · Sep 13, 2009

It depends what kind of unit your on I guess. If someone requires suctioning to clear their airway emergently then obviously you just need to do that with or without an order. Common sense kind of prevails here, seems to me. You probably want to let them know that you are needing to sxn someone if they hadn't needed that before/if that was a change (may need treatments/meds to help), or they may need to have closer observation or whatever.

wooh, BSN, RN · Sep 13, 2009

We have orders for suctioning, but we can suction without them. They'll always write an order *not* to if there's a reason we shouldn't. I think getting the order allows us to charge for it somehow. As Jennifer said, if they need their airway cleared, that's basic life support, clear their airway!

miss81, BSN, RN · Sep 13, 2009

We don't need an order in my facility, that's a nursing intervention. If the pt is vented or trached then the nurses trained to care for those pt's make the call. You should check your hospital's P&P though. But as Jenniferhope said in a PP, you should inform the PCP if you are suctioning a pt that didn't previously need suctioning or is having increased secretions as the may need a change to their meds to help. For example, adding Scapolamine for a palliative pt with increased secretions, etc.

On the other hand there was a thread on here recently that suggested some hospice pt's do not get suctioned. I do not work hospice so I am not familiar with their practice. However, I think that in most cases it is BLS and remember your ABC's:nurse:

locolorenzo22, BSN, RN · Sep 14, 2009

generally, hospice do not get suctioned due to the invasiveness of the procedure, but I will clear secretions quickly if the pt is choking on them.

rachelgeorgina · Sep 14, 2009

A yanker sucker shouldn't be to invasive, considering what choking on secretions would feel like. On the other hand, I can imagine that deeper suctioning must be more uncomfortable and invasive and I can see why that would be contraindicated in hospice.

SunnyAndrsn · Sep 14, 2009

I have done oral suction for hospice pts. when they are actively dying, especially if atropine drops don't help. Oral suction is a part of our standing orders.

generally, hospice do not get suctioned due to the invasiveness of the procedure, but I will clear secretions quickly if the pt is choking on them.