Suction or no suction!

Hi Guys,

i need an urgent suggestion on plan of action to the below scenario:

The nurses have referred Mr X to you. He has a diagnosis of left lower lobe pneumonia. On assessment he is short of breath with a respiratory rate of 40. He is slumped in bed with sats of 95% on 9 litres of oxygen via nasal specs. You have already established that he has a very weak, ineffective cough and coarse crackles throughout with tactile fremitus. You decide that suctioning is an appropriate treatment but you have not done suctioning before.

Thanks

Get someone else to do it? Just ask a more experienced physio to do it and show you how. I don't think anyone is going to think less of you because of it. They may think you are an idiot if you try something you haven't done before on someone so sick!

Also, why 9L of oxygen through the nose? I thought that the max was 2L/min and anymore wasn't going to be effective?
Mind you - i am a musculoskeletal physio hahahaha :p

Sit your patient bolt upright and see if cough is anymore effective. You could try Yankauer to back of throat in case its just secretions caught there. Otherwise get someone to show you how to suction nasally and consider putting in a nasopharangeal airway if you are going to have to do it repeatedly (causes less trauma). Also get your patient onto a facemask with humidified oxygen and check they are on regular nebulisers to loosen secretions. Hope this helps!!