Open Catheter Suctioning guide

What is suction?

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 suctiontube /Yankauer to remove these secretions.

A reduction in the amount of secretions in the patient’s chest can 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 are too thick or the patient is unable to cooperate, suction can be used to assist.

How is suction used?

Dependent on the location of secretions 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 the technique involve?

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

1. Set the Suction pressure 20 cm H20.
2. Open the catheter packaging at the end you wish to attach to the suction apparatus.
3. Connect the catheter to the suction connection tube.
4. Pull out 15cm of catheter and double over being careful not to touch the exposed part of the catheter and place this under your left arm.
5. Put on sterile gloves. These should only touch the exposed sterile catheter prior to or during suction.
6. Insert the catheter to the depth documented by your therapist.
7. If resistance is met withdraw suction catheter slightly before applying suction.
8. Apply Suction by covering the open hole closest the patient while slowly and smoothly withdrawing the catheter.

Cleaning

Never re-use a suction catheter. Suction sterile or put cooled recently boiled water through the  interconnecting tubing.

How often?

It is recommended suctioning should be provided when there are secretions present that are harmful to the patient and cannot easily be cleared by other methods,  for example secretions potentially restricting the patient's breathing. If you are unwell, or have an active chest secretions, you may need to increase how often you suction.

Other useful pointers

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 prolonged shortness of breath when suctioning.

Breathing 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 as you take a breath in. This is an ineffective way of breathing, when recovering from suction.

How to Tummy Breathing when recovering from use of the Positive Expiratory Pressure (PEP)

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 breath in through your nose. Feel your lower chest expand. Open your mouth wide to make a big O with your lips and blow the air out through your open mouth. Practice by steaming up the mirror.

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