For patients having trouble removing secretions or foreign matter from their mouth by effective coughing, oral suctioning can be beneficial.
Oral suctioning is usually performed using an instrument called a Yankauer suction, which is a rigid plastic or metal suction device with a connection end for the suction tubing at one end and a small bulb with holes at the other end.
Patients who benefit the most from oral suctioning include those with CVA’s, drooling, impaired cough reflex and those challenged with an impaired swallowing condition.
Some patients can perform the oral suction procedure on themselves.
It is important to note that patients with an impaired swallowing condition are susceptible to aspirating fluids, and as a precautionary measure should always have a suction machine with Yankauer suction nearby and at the ready.
You want to avoid going over any sores or sutures in the mouth. You also do not want to go so far in the back of the throat that you stimulate the gag reflex.
How to perform oral suctioning on a patient:
- Assess the patient to make sure they are not in any respiratory distress or overly anxious. Be aware if the patient has a strong risk for aspiration.
- Explain to the patient what procedure you are going to do and what they should expect.
- Place the patient in a semi-fowlers position (45 degree angle in bed).
- Wash your hands.
- Gather supplies, a basin with tap water, and non-sterile gloves. If the patient has an infectious disease, you may want to wear a face mask to avoid any bodily fluids.
- Turn the suction machine on and connect the Yankauer suction device to the suction tubing. Adjust the suction pressure to between 15” and 20” Hg. You will have immediate suction going through the handle tip unless your Yankauer has a thumb control which, when covered, will create the suction.
- Make a slow sweeping motion towards the back and sides of the tongue to clear out any excessive secretions at the back of the mouth. If the patient is able, have them pucker their lips with their mouth closed while moving the suction tip to the front of their mouth. This will usually clear any other secretions that were towards the front of the mouth.
- This process should take no longer than 10 seconds of total time. Repeat if necessary. When completed, turn the suction machine off and ensure that the patient is not in any discomfort or distress.
After oral suctioning is complete:
- Insert the Yankauer suction tip in the basin of water and thoroughly rinse the suction tip as well as the suction tubing. Allow air from the suction machine to run through both to help dry.
- Wipe the Yankauer with warm water and mild dish detergent and dry with a clean paper towel.
- Place the Yankauer in its original wrapper or cover with another paper towel to keep the Yankauer free of dirt and dust.
- Rinse the collection jar and tubing with warm water and mild soap detergent.
- The Yankauer can be reused frequently. In the home setting, it would probably be recommended to change weekly if it is cleaned thoroughly and properly stored. A hospital is a totally different environment and should be changed much more frequently, if not daily.
