Competency Training for Staff Patients Family and Carers Draft February 2019 Definitions Suction is a procedure for clearing secretions from the mouth or airway It can be used when an individual cannot clear secretions independently with a cough ID: 1010646
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1. Use of Oral Suction in the communityCompetency Training for Staff, Patients, Family and CarersDraft February 2019
2. DefinitionsSuction is a procedure for clearing secretions from the mouth or airway. It can be used when an individual cannot clear secretions independently with a cough.Oral yankauer suction is the insertion of a Yankauer suction device into the mouth in order to remove sputum, saliva or aspirate.Draft February 2019
3. EquipmentFunctional suction unit – DeVilbiss drive unitOral yankauer tubePatient pack of tubing/bubble tubingSterile or cool boiled water and jugPersonal protective equipment (if required)Draft February 2019
4. Process for ordering equipmentConsumables required for oral suction in the community;Suction Canister – this fits into suction unit itself. Single use – to be used for one patient only, as long as required.Filters – fit into the lid of the canister. Filters are to be changed every 2 months or sooner if soiled. They must not get wet.YankauersSuction tubingDraft February 2019
5. Procedure – Oral Suction with Yankauer TubePrecautions:Facial fracturesLoose teeth/DenturesClotting disorders Laryngeal / oral carcinoma Severe bronchospasm Stridor Restless / anxious clientHead and Neck SurgerySore mouth/damaged mucosaFitting patient/ spasms or increased muscle tone of face and neck musclesDraft February 2019
6. Indications for Oral SuctionSome indications for suction:Inability to clear own secretions Frequent productive cough Audible coarse secretionsVisible secretionsOtherwise unexplained shortness of breath (SOB) Decrease Sp02 (oxygen saturations) as assessed by HCP (Health Care Professional)Suspected aspiration of stomach contents into airway – AspirationDraft February 2019
7. Clinical Procedure - 1Explain procedure to patient and gain consentSwitch on machine and ensure working correctlyCheck suction pressure - 100-150 mm Hg for use with adultsWash hands and apply PPE if appropriateDraft February 2019
8. DeVilbiss machine Demonstration on use of the machineDraft February 2019
9. Clinical Procedure - 2Position the patient in a comfortable, head up position with their head turned towards you. Open yankauer suction tube and attach to tubing. Insert into patient’s mouth, ensuring it does not go beyond the teeth. If the patient is able allow them to self-suction. Ensure you have a view of the oral cavity during suction to ensure the tube does not come into contact with the oral mucosa.Apply suction on withdrawl of the yankauer tube, working around the mouth.Note quantity, colour and tenacity of secretions. If there has been a change in secretions or they look infected, liaise with the patient’s GP to allow a sputum sample to be taken. Document use of suction and secretions obtained in care notes.Draft February 2019
10. Clinical Procedure - 3Ensure the mouth cavity is clear and the patient is breathing comfortably.Assess the patient’s response to suctioning and reassess the need for further suction.Rinse the yankauer tube and suction tubing through with sterile or cool boiled water. Dispose of PPE and wash hands.Draft February 2019
11. Points to noteDo not pass the yankauer sucker pass the back of the teeth to avoid stimulation of airway reflexes.Ensure that the soft tissue does not come into contact with the suction tube to prevent tissue damage. To set the suction pressure: Turn on the suction at the unit/ machine. Ensure the patient tubing is attached to the suction unit/ machine. Kink the suction tubing. Observe the dial on the suction unit; adjust the pressure using the pressure regulator knob to the desired level:Adult 12-20 kPa or 100-150 mm Hg Draft February 2019
12. Possible complications of suctionDistress to clientTrauma to oral mucosa – particularly important for those individuals with clotting disorders.Bronchospasm/bronchoconstrictionAirway infectionBleedingPain / discomfortDraft February 2019
13. Machine MaintenanceDisconnect the tubing and remove the container from the holderCarefully remove the lid and empty contents into the toiletNote – container should be emptied and cleaned after each useRemove the filter cartridge and set aside.Wash container, lid and splash guard in warm water/dishwashing solution. Rinse with clean, warm water and air dry.A vinegar solution (1 part vinegar to 3 parts hot water for 60 minutes) can be used if preferred. The disassembled container may also be washed in a dishwasher, top shelf only, using a cycle with a water temperature between 55-65 degrees Celsius.The machine filter must be changed is overflow occurs, or every 2 months.Draft February 2019
14. Machine MaintenanceHealthcare equipment providers, NRS will maintain the suction unit by performing annual checks.If you have any problems with the unit, please ring NRS. NRS will repair/replace faulty equipment.Draft February 2019
15. Disposal of consumablesYankauer and suction tubing should be changed when they become soiled or discoloured and are unable to be cleaned or if they split.Filters should be changed every 2 months.The canister should remain in place for the entire time the patient requires suctioning.Consumables can be disposed of in the black bin collection.Draft February 2019
16. Queries and QuestionsAdvice for family/patient/carers If you have any concerns or questions about the suction process, please contact the professional prescribing the suction machine.If you have any concerns about the suction machine itself – please contact NRS.Draft February 2019