Suctioning Question

[Nursingblue]

Hello everyone, I am studying for the NCLEX and I'm confused about suctioning a tracheostomy. Do you suction the mouth first or the trachea first? I learned that you suction from sterile to clean so from the trachea and then the mouth. Uworld states you suction the mouth first but I disagree. Any thoughts? Thank you!

[Rose_Queen, BSN, MSN, RN]

Would you be using the same type of suction catheter for both mouth and trachea?

[KelRN215, BSN, RN]

I honestly cannot recall a time in the past 11 years when I've had to orally suction someone with a trach.

But, as Rose_Queen said, it's not like you're going to be suctioning a trach with a yankauer or a mouth with a catheter.

[vanilla bean]

I honestly cannot recall a time in the past 11 years when I've had to orally suction someone with a trach.

All. The. Time. Many trached adults who have also suffered some sort of CVA have difficulty managing oral secretions.

[sallyrnrrt, ADN, RN]

Both, if unruffled trach I like to suction trach first......and the mouth pharynx with like a yanker......even unruffled I like to doo trach first

[Imreks2014]

I m an icu nurse .we use same tubing but with a y connector for oral and tracheal auctioning.we use yanker for mouth .we should clear mouth first as it can be aspirated if too much collection ,also if u didn't clear mouth first it will splash when pt coughs while doing tracheal suction.

This is my practical experience.

I hope it will help you

[NurseDrizzles, BSN, RN]

Hi! I'm a respiratory stepdown nurse and I suction trachs on the regular. Generally you suction the trach first. This will cause the patient to cough, causing a buildup of secretions in their mouth. I always have a yankauer nearby ready to go so I can pull the suction cath off (and dispose) and pop the yankauer on. I don't recommend putting the same catheter in their mouth and it probably won't work as well anyway. Remember to always do good oral care on your trached patients. I hope this helps!

[NurseDrizzles, BSN, RN]

Do you guys use in-line suctioning? I imagine most of your patients are vented. On unvented patients, we generally use a new sterile catheter for each time we suction. The splitter can be helpful. With more tenacious secretions I'll usually set up a separate container for each so I can get maximum (safe) suction on each one. When those secretions are thick, it's a nightmare.

[Imreks2014]

Each time u have to use new catheter.but yanker no need.after use u will irrigate it wilth irrigation saline . tracheostomy suction is a sterile one ,not to introduce organisms

[KelRN215, BSN, RN]

Hi! I'm a respiratory stepdown nurse and I suction trachs on the regular. Generally you suction the trach first. This will cause the patient to cough, causing a buildup of secretions in their mouth. I always have a yankauer nearby ready to go so I can pull the suction cath off (and dispose) and pop the yankauer on. I don't recommend putting the same catheter in their mouth and it probably won't work as well anyway. Remember to always do good oral care on your trached patients. I hope this helps!

My trached peds patients tend to hack loogies out of their trachs rather than pool secretions in their mouths.

[ffooxx]

What nurses do in real life may not match what nurses are supposed to do per NCLEX :) This is what Saunders says:

Suction oropharynx/oral care first

Pre-oxygenate with 100 Fi02

Suction

Oxygenate again and auscultate the lungs

[Daddie O, BSN, RN]

There is a lot of bacteria in the mouth, and if you don't do oral suction first you may introduce bacteria into the respiratory tract.