Closed System Suctioning guide

What is suctioning?

Suctioning is a process that aims to clear the build-up of harmful secretions from someone’s chest. A suction machine mechanically draws air in through a suction tube/yankauer to remove these secretions.

A reduction in the amount of secretions in the patient’s chest will help their breathing. Conditions such as bronchiectasis and chest infections can produce excessive harmful bronchial secretions. This can result in blocking of airways leading to impaired respiration.

Physiotherapy aims to achieve independent patient chest clearance however if the patient is too weak, secretions too thick or the patient is unable to cooperate suction can be used to assist.

Tasks required for suction

Test your breathing

Place one hand on your upper chest and one hand on your stomach, just below your ribs. You will probably feel your top hand move more than your bottom hand as you take a breath in.

This is an ineffective way of breathing when recovering from using suction, you should be tummy breathing.

How to tummy breathe when recovering from Suction

Breathe in slowly through your nose then out through the mouth. Aim to make your stomach rise as you breathe in and fall as you breathe out.

The aim is to relax your breathing. Try to slightly reduce the depth and rate of your breathing to reduce recovery time.

It is very difficult to change your breathing pattern, however, if you practice daily it will become more natural.

Huff

Take a slow half breathe in through your nose. Feel your lower chest expand.

Open your mouth wide to make a big O shape with your lips and blow the air out through your open mouth.

Practice by steaming up the mirror.

How is suction used?

Dependent on the location of secretions, a suction catheter (flexible long tube) or a Yankauer (hard shorter tube) will be used to remove these secretions.

Suction can be combined with other physiotherapy techniques which move secretions to a point they can be more easily removed. Removal of secretions allows for improved air entry, re expansion of lung tissue and reduced incidence of chest infection.

What does suctioning involve?

Your physiotherapist will advise how to perform suction correctly. On receiving this advice follow the below method:

1. Connect the apparatus to the system. Push 3cm of the catheter in ruffling up the outer sheath.

2. Set the Suction pressure to 20cmH20.

3. Unlock the valve by rotating the switch.

4. Push 3cm of the catheter in ruffling up the outer sheath.

5. Slide the outer sheath back over the catheter without moving it.

6. Repeat the above two steps until a gentle resistance is met.

7. Withdraw suction catheter slightly (1cm).

8. Apply Suction whilst slowly and smoothly withdrawing the catheter. The above should take no longer than 20 seconds.

Cleaning

With the catheter fully withdrawn, continuously apply suction while running sterile saline through the portal by the trachea of the closed system.

How often?

It is recommended that suctioning be provided for secretions potentially restricting the patients breathing that cannot be cleared by other methods.

If the patient is unwell or has an active chest secretions, suction use may need to be increased. If treatment is making a patient excessively tired, reduce the treatment time while increasing the number of treatment sessions.

Additional useful points

1. Always check the patient is not distressed before re-suctioning.

2. Suctioning can be combined with other treatments such as postural drainage or percussions and vibrations.

3. Seek advice from your therapist if you notice blood in your sputum, chest pains or significant or prolonged shortness of breath when suctioning.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk