GUIDELINES FOR PERFORMING SUCTION IN CHILDREN
AIM
To maintain a patent airway and promote adequate ventilation
INTRODUCTION
Sick children cannot move secretions effectively, therefore these secretions must often be
removed by suction.
Suction is indicated for secretions audible in the airway, signs of airway obstruction or
signs of oxygen deficit. Always try to arrange to carry out suction prior to child’s feed and
avoid suction for at least 1 hour afterwards to reduce the risk of vomiting.
SCOPE
All staff who are trained and competent
EQUIPMENT
Wall suction unit with container and connecting tubing
Wall oxygen with oxygen tubing and mask
Suction catheters size 6 FG – 10 FG
Non-sterile gloves
Small disposable foil bowl filled with water
Distilled water
ACTION RATIONALE
1. Explain the procedure to the child and 1. To gain co-operation from the child and
family parents and to lessen anxiety about the
procedure
2. Obtain assistance 2. To support the child
3. Offer the parents the option of staying for 3. Some parents may need permission to
the procedure leave
4. Wash and dry hands thoroughly 4. To minimise risk of infection
5. Assemble equipment 5.
6. Place the child on his/her side, upright or 6. To prevent aspiration if patient does
in a comfortable position vomit
7. Switch on suction and attach catheter but 7. There must always be enough space
leave in packaging. around the catheter to allow air to pass in
– it must not be a ‘neat’ or tight fit
Catheter size infants – 6G, 7G, 8G
Catheter size children – 7G, 8G, 10G
8. Adjust amount of suction 8. This provides adequate vacuum to
Infants: 70 – 100 mmHg 15 kPa remove secretions without causing
Children: 90 – 110 mmHg 15 – 20 kPa trauma to nasal/mouth mucosa
9. Administer oxygen via face mask for at 9. To try to prevent suction-induced hypoxia
least 1 minute before suctioning and after and bradycardia from occuring
if needed
10. a) Put on gloves 10. a) To minimise the risk of infection
b) Remove the sterile catheter from the
wrapper, grasping the catheter with the
dominant hand without letting either
glove or catheter touch anything
c) To determine how far to insert the
catheter, measure the distance c) Insertion of the catheter further than
between the tip of the nose and this measurement may cause
external opening of the ear vomiting and aspiration
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ACTION RATIONALE
11. a) Lubricate the end of the catheter with 11. a) Lubricant decreases the trauma of
saliva from the child’s mouth or use the catheter on the nasal mucosa
sterile normal saline or water
b) Gently insert the lubricated catheter
into a nostril, using an upward motion
until the nasal septum is passed, then
use a downward motion without suction
12. Suction should be applied on withdrawal of 12. Suctioning will not cause mucosal trauma
catheter only. Place thumb on suction port and will not make the child hypoxic
13. Each suctioning attempt should last only 5 13. The child will be free from hypoxia and
– 15 seconds, this may stimulate a cough. dysrhythmias associated with suctioning
Allow at least 30 seconds for re-
oxygenation and recovery between suction
14. Repeat in the other nostril 14.
15. Suction secretions from the mouth either at 15. Depends on child, may stimulate a cough
the beginning or the end which will aid removal of secretions
16. Repeat suctioning as many times as 16. The child’s status (oxygen saturation)
needed, using the above technique and type of secretion will dictate the
frequency with which the suction
procedure is performed
17. After suctioning remove and dispose of the 17. This prevents transmission of micro-
gloves and suction catheter according to organisms
Hospital Policy
18. Flush connecting tubing with water from 18. To remove secretions from the tube
foil bowl. Change foil bowl after use
19. Turn suction off
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ACTION RATIONALE
20. Wash and dry hands thoroughly 20. To minimise the risk of cross infection
21. Comfort the child after the procedure 21. Reassure the child that he/she has done
very well during the procedure
22. Record the colour, amount and 22. The child’s medical record will reflect the
consistency of the secretions suctioning procedure and the results
REFERENCES
1. Allen D, (1998) Making Sense of Suctioning. Nursing Times, Vol 84, No 10, p46-47
2. Macmillan C, (1995) Nasopharyngeal Suction Study Reveals Knowledge Deficit. Nursing
Times, Vol 91, No 5, p 28-30
3. Skale N, (1992) Manual of Paediatric Nursing Procedures, J B Lippincott Company
4. White H, (1997) Suctioning A Review. Paediatric Nursing, Vol 9, No 4, p 18-20
REVIEW
As national, regional, local or profession bodies require
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