When performing suctioning on a patient, you should:

Appeared in: ESIC Nursing Officer -2019 (Shift -1)

Explanation

Pre-oxygenation with 100% oxygen for 30-60 seconds before suctioning is a critical step to increase the patient's oxygen reserves.
This preventative measure helps to avoid hypoxemia (low blood oxygen), which can occur when air and oxygen are removed from the lungs along with secretions.
Post-oxygenation after the procedure helps restore the patient's functional residual capacity and returns oxygen levels to their baseline.

Option B: Suctioning for longer than 10-15 seconds per pass significantly increases the risk of severe hypoxemia, mucosal trauma, atelectasis, and cardiac arrhythmias.
Option C: Applying suction during catheter insertion will damage the tracheal and bronchial mucosa, causing bleeding, inflammation, and swelling. The catheter should be inserted gently without any suction.
Option D: Applying continuous suction during insertion is extremely traumatic to the airway lining. It combines the errors of suctioning during insertion and applying continuous instead of intermittent suction.

Visual 1: Diagram: Step-by-step illustration of the correct endotracheal suctioning procedure, showing pre-oxygenation, catheter insertion without suction, and intermittent suction on withdrawal.
Visual 2: Chart: Comparison of correct vs. incorrect suctioning techniques and their potential outcomes (e.g., hypoxia, mucosal trauma).

Clinical Relevance

Nursing practice connection: Use the key finding related to Correct procedure for respiratory suctioning to guide bedside assessment, documentation, and the next nursing action.
Proper suctioning technique is a fundamental nursing skill to maintain a patent airway in ventilated or compromised patients, directly impacting patient safety and preventing iatrogenic injury.
In a patient with already borderline oxygen saturation (e.g., 91-92%), failing to pre-oxygenate adequately before suctioning can lead to a rapid and critical desaturation event, potentially causing cardiac arrest.
What if? If the patient's heart rate drops significantly (bradycardia) or other arrhythmias appear on the monitor during suctioning, the procedure must be stopped immediately, the patient should be re-oxygenated, and the healthcare provider notified.

How to Approach the Question

First, identify the core nursing procedure in the question: suctioning.
Recall the principles of safe patient care related to this procedure. The primary goal is to clear secretions while minimizing harm.
Evaluate each option against safety principles. Does the action prevent a complication or cause one?
Option A (oxygenation) is a preventative safety measure. Options B, C, and D describe actions that are known to cause complications like hypoxia and mucosal trauma.
Therefore, the correct action is the one that promotes patient safety and prevents adverse events.

Concept Tested & Keywords

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Practise the full ESIC Nursing Officer -2019 (Shift -1)

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