suctioning

WSU_Ally_RN, BSN, RN · Feb 27, 2006

when I do it, I go all the way down till you feel like you're hitting something... that's the carina. then you start suctioning.... so i guess my answer is yes, you can go down further than the nasopharyngeal area.

Noryn · Feb 27, 2006

when I do it, I go all the way down till you feel like you're hitting something... that's the carina. then you start suctioning.... so i guess my answer is yes, you can go down further than the nasopharyngeal area.

Will suction catheters reach the carina when you go through the nose? Also will the catheter actually go into the trachea? When they are on a vent you have a direct line to the carina although I never went until I hit something. Usually when you are at the carina with the tubing that will activate a coughing reflex.

However when I go through the nose or the mouth (which can be a huge debate) I usually try to go mid throat area.

It has been so long ........sigh so hopefully some more experienced nurses will reply. Like I said I dont know if you can necessarily hit the carina going through the nose--I would think the tube is too short and usually the opening to the trachea is going to be closed unless you catch them inhaling and exhaling. I will stand corrected if I am wrong but I would never try to get a suction cannula into their trachea like this.

I do remember someone suctioning through the mouth one time and getting all kinds of crap and I walked in. I was like OMG you are in the stomach and sure enough they were in the stomach....

Tweety, BSN, RN · Feb 27, 2006

Nasotracheal suctioning can be done. Usually it's done best by a respiratory therapist.

Usually when I NT suction I go until I stimulate a cough and that's usually good enough. It's hard to truly NT suction, most of the time we go down the throat and esophogus. One way to tell is to listen for air at the end of the tube (but the are usually coughing by then anyway). I had one RT tell me it's easier to NT if you ask them to cough or go down and wait for a cough and then advance a bit further, but I can't tell you the patho behind that.

http://www.rcjournal.com/contents/09.04/09.04.1080.asp

TexasPediRN · Feb 27, 2006

I do remember someone suctioning through the mouth one time and getting all kinds of crap and I walked in. I was like OMG you are in the stomach and sure enough they were in the stomach....

Oh my...

jmgrn65, RN · Feb 27, 2006

I don't think going until you hit 'something' is a good idea, you are causing trauma and remember during suctioning there aren't breathing, it is a good idea for you to hold your breath while suctioning so you have an idea of when to stop. I usually go down until they are coughing, because they are coughing and helping stuff to come up.

danigirl58 · Feb 27, 2006

HI all I just want to put in my 2 cents worth on this one. 2 weeks ago we had a patient that was palliative - he had lung Ca- his breath sounds were very course and he had the rattle going. We (I'm a nursing student doing senior practicum) decided to try to suction him through the oral route, which i can say didn't work because he wouldn't stop bitting the catheter. So instead we put in a nasal trumpet and went through the nasal pharyngeal route. I was surprised at how far the catheter actually went down. we got a lot of junk out of his lungs and his breathing and sats improved.

On a side note I'm on a respiratory/thoracic unit and I have yet to see a person being suctioned orally or through the nasal pharyngeal route where he catheter went into he stomach. I'm sure it can happen but i have yet to see it.

zacarias, ASN, RN · Feb 27, 2006

I'm not that familiar with NT suction has RT has always done it and I don't work critical care. My question, is RT able to suction down into the trachea or do they often get into the esophagus too?