Airway Suctioning Procedure

Key Points

• Suction only when clinical signs indicate retained secretions or airway obstruction risk.
• Preoxygenate with 100% FiO2 before lower-airway suctioning.
• Keep each suction pass under 15 seconds and allow 30-60 seconds recovery between passes.

Equipment

• Suction source with adjustable pressure
• Appropriate catheter system (Yankauer, sterile open catheter, or closed in-line catheter)
• Personal protective equipment and sterile gloves for open/nasotracheal suctioning
• Pulse oximetry and routine vital-sign monitoring setup

Procedure Steps

1. Confirm clinical indication for suctioning and assess baseline oxygenation and respiratory status.
2. Explain the procedure to awake interactive patients and prepare bedside equipment.
3. Preoxygenate with 100% FiO2 before lower-airway suctioning.
4. Set suction pressure for age group: adults -100 to -120 mm Hg, children -80 to -100 mm Hg, infants -60 to -80 mm Hg.
5. For open/nasotracheal technique, don sterile gloves and maintain sterile handling of the catheter.
6. Choose correctly sized catheter (less than 50% of ETT internal diameter when suctioning artificial airway).
7. Insert catheter to the target depth; for artificial airway suctioning, do not advance beyond the tip of the airway.
8. Apply suction while withdrawing catheter and keep total pass duration under 15 seconds.
9. Allow 30-60 seconds recovery, reassess oxygenation and clinical response, then repeat only if still indicated.
10. Avoid routine saline instillation through the endotracheal tube.
11. Document indication, suction pressure, number of passes, patient response, and post-procedure assessment.

Common Errors

• Performing routine suction without clinical indication → unnecessary mucosal trauma and hypoxemia risk.
• Excessive suction duration or pressure → airway injury and oxygen desaturation.
• Advancing catheter too deeply → bleeding and tracheobronchial trauma risk.
• Breaks in sterile technique during open suction → increased contamination and infection risk.

Related

• airway-suctioning - Concept-level rationale for suction indications and safety limits.
• tracheostomy-care-procedure - Tracheostomy management includes ongoing secretion clearance and airway patency checks.