Mucus Suction Technique(suction) I. Theoretical Concepts 1. Understanding Mucus suction (suction) is a nursing action carried out on clients who are unable to expelsecretsor sputum or mucus independently using a suction device.This suction is usually done through the mouth, nasopharynx or trachea. 2. Suction Type - Open Suction:Suctionwhich is carried out on patients without being connected to a breathing machine (ventilator). - Closed Suction:Suctionwhich is carried out on patients where during the proceduresuctionconnected to a breathing machine (ventilator). II. Objective To maintain airway patency so as to enable adequate gas exchange processes to occur by removing secretions/mucus/sputum in clients who are unable to expel it themselves. III. Indication 1. Therapeutic a. There is a secret in the airway b. IncreaseSpO2 on the pulse oximeter c.Intervention of arterial blood gas values(BGA) d.Clinically increased work of breathing e.Suspected aspiration of gastric or upper airway secretions f.Patient's inability to generatean effective spontaneous cough g.Changes in monitored flow/pressure graphics h.Increased PIP (Peak Inspiratory Pressure); decreased Vt during ventilation 2. Diagnostics Takingsputum specimen / ETA (Endo Tracheal Aspiration) for Bacteriological or microbiological or cytological investigations IV. Contraindications Contraindicated in clients who experience disorders that can cause laryngospasm (especially as a result of suction through the trachea), bleeding in the mouth and airways, laryngeal edema, esophageal varices, tracheal surgery, gastric surgery with anastomosis and myocardial infarction. V. Procedure - PreparationPatients - Explain the procedure(If patient is conscious). - Dohyper oxygenation by the delivery of 100% oxygen for >30 seconds before the suctionng (Either with Bain's circuit or by increasing the FiO2 by mechanical ventilators). - Position the patient in supine-hyperextension position. - Auscultate the breath sounds - tools preparation (STERILE PRINCIPLE) - Suction catheter (disposable) – Noe-Baby 6 Months : 6-8 Fr – 8 Months-22 Months : 8-10 Fr – 2-7 years : 10-12 Fr – 7-10 years : 12 Fr – Mature : 12-16Fr - Sterile gloves - Medium sterile tub - Sterile comm (filled with NaCl) - Tongue spattel, gauze (used if the client is unconscious & restless) - Tweezers (If Necessary) -Everything is put in a sterile instrument container Non-Sterile Equipment - Oxygen cylinder and oxygen cannula Suction machine: For adults a pressure of 100-120 mmHg; For children 80-100 mmHg; For infants 60-80 mmHg - Bent - Disinfectant solution - Tissue - Jelly (if needed)