Flexible catheter suctioning is useful for suctioning smaller airways such as those found in pediatric patients or patients who have an advanced airway in place. EMT's may not suction farther than is readily visible unless specifically allowed by local protocol. Flexible suction catheter length is measured by the length between the mastoid process (or lower earlobe) and the nose; if you'll notice, this is similar to the measurement for a NPA. Flexible catheters may be fed down the nares if necessary as well as inserted into advanced airways. A stoma should always be suctioned with a flexible suction catheter.
Both flexible and rigid suction tips can be "Whistle-tip" configuration meaning they have an opening close to where the tip attaches to the large diameter suction tubing in addition to the suction opening at the end. This "whistle" opening provides an alternate entry for air into the tip which means that suction at the end is very weak when this hole is open. Placing a finger over the opening directs all the suction to the tip, turning it "on". If the suction catheter does not have an opening, suction at the tip is continuous as long as the suction unit is on.
Suctioning
- Assemble. Attach the both vacuum side of the pump and the vacuum tubing to the fluid collection canister.
- Test. Turn the vacuum pump on, and test the tubing connections by bending the vacuum tubing to occlude it and listen for the sound of the pump to change indicating it is working harder. If this does not happen, check the airtightness of the seals between the vacuum pump, the canister and the tubing, and check that the canister lid is seated.
- Measure. Attach the appropriate tip for the type of suctioning being performed, and measure from the tip of the nose to the ear lobe on the patient to note how deep to insert the suction tip
- Suction. Insert the suction tip to the measured depth and then cover the whistle opening to suction only while withdrawing. For catheters without a whistle opening, the tubing may be kinked during insertion to prevent suction during insertion. Suction for no more than 15 seconds in an adult, 10 seconds in a child and 5 seconds in an infant
- Rinse. Suction tips may become clogged or jammed with debris, withdraw the tip and remove debris and flush with water as needed to maintain adequate suction.
- Oxygenate. Oxygen administration should be provided after suctioning.
