did suctioning caused hypoxia?

[Ms.RN]

i had a trach patient and she was gurggling with secretion and when i checked her pulse ox it was 93%. so i suctioned her and gave her a breathing treatment. one hour later i checked her pulse ox and it went down to 80's and couldnt bring it up to more than 90%. my question is do you think my suctioning the patient caused her to drop her pulse ox?

[libbyjeanne]

It is hard to say if the suctioning was the actual cause of her hypoxia, although it definently could have been the reason. Before I suction my trach patients, I hyperoxygenate them beforehand to prevent a hypoxic episode afterwards.

[GOMER42]

No.

The hypoxia that would occur with suctioning would be immediate- not an hour later.

[leslie :-D]

No.

The hypoxia that would occur with suctioning would be immediate- not an hour later.

the o2 sat was taken an hr later.

doesn't mean o2 wasn't down immediately after...

just that it wasn't taken at that time.

yes op, it is possible it could be r/t the suctioning, but nothing a little supplemental o2 shouldn't take care of.:)

leslie

[traumamike]

As a former RT, I agree with leslie and Libbyjeanne, Yes that is most likely the cause and yes it can be taken care of by pre-oxygenating the patient. It happens even then sometimes, just one of those things, and yes it most likely dropped immediately, but not all pulse oximetry waveforms are good. Did the waveform look like an 80% desat. or was it all over the place? Of course the only true way to tell if the oximeter is correct is to corralate the pulse ox with an ABG, but only do this if the pt. has an ART-line. Due to not having to needlessly stick your pt. Good luck!

[RNperdiem, RN]

Check the placement of the oximeter. A half pulled off or out of position pulseox can give you inaccurate results.

How did the patient look. Did they seem to be in respiratory distress?

You did everything I would have done.

[anurseuk]

It sounds like the patient needed possibly more suctioning. Suctioning alone will not cause hypoxia... unless I suppose you're a little to vigous and rupture something while your down there? And when a patient is drowning in their own secretions there is no other option.

What do you mean by a breathing treatment? Nebulisers, physio etc?

Had her saturations recently dropped to 93% or was this normal for her? Did her trachy have an inner tube, and was that checked?

What was the outcome?

[talaxandra]

I was taught to hyper-oxegenate prior to suctioning to reduce the risk of transitory hypoxia. Of the many trache patients I have looked after none have been hypoxic an hour later unless there was an underlying reason like increased secretions or a partially occluded cannula.

[iwanna]

I can say that as a patient, I was usually hyper-oxygenated prior to suctioning.

Did you check all of the patient's vitals afterwards? And, did they seem to be in distress? I know the pulse-ox can be very sensitive, and plenty of times I have had inaccurate readings. Then, I would do a further assessment, e.g. vitals, capillary refill, etc. And perhaps, grab another pulse-ox. Also, I would check the pulse-ox on myself to see what kind of reading that I got.