Suctioning Technique: Oropharyngeal, Nasopharyngeal, and Endotracheal

Suctioning removes pooled secretions that the patient cannot clear independently. Oropharyngeal suctioning clears the mouth and pharynx; nasopharyngeal suctioning clears secretions from the nasal passage and nasopharynx; endotracheal suctioning removes secretions from an artificial airway. Retained mucus narrows the airway and increases resistance to airflow. It can produce coarse or gurgling sounds, visible secretions, increased work of breathing, falling oxygen saturation, and difficulty feeding when nasal congestion is the cause. Suctioning may improve air movement and oxygenation when retained secretions are the problem. A low oxygen saturation or respiratory distress without evidence of retained secretions has another differential. Bronchospasm, pulmonary edema, pneumonia, pneumothorax, impaired ventilation, and circulatory deterioration are not corrected simply by passing a suction catheter. Assess the whole patient rather than treating the monitor number alone. Suctioning can itself reduce oxygenation, irritate airway tissue, provoke vagal bradycardia, and cause bleeding. That is why it is performed for clinical indications, not on a routine schedule or merely because a catheter is available.