Hello Our ambulatory healthcare centers only have suction as an independent unit on top of our emergency cart. They are taught to use the bulb suction for babies. Deep suction has always been qualified as an advanced skill. None of our nurses are trained in my current ambulatory environment.
I used to work on a Critical Care Ambulance as a Critical Care RN and any patients that needed deep suctioning required an RN for transport. EMT's were not allowed to transport patients that required deep suction as this is considered a higher level skill. I can speak from experience that those were some of my worst suctioning experiences as it's an uncontrolled environment without additional support. I'm an experienced Critical Care nurse so could handle the situation. However, some of these patients with long term tracheostomies are bedbound in skilled nursing facilities with minimal movement. All the movement in the transport can dislodge a lot of mucus. There was a patient that had to be suctioned for almost 30 minutes due to heavy secretions that got dislodged. As an experience nurse, I varied the technique and didn't go deep everytime and tried other techniques. If the staff is taught the standard of going down twice for less than 10 seconds each time; suction on exhalation and twirl the suction catheter as you slowly remove it, that only solves the technique. Unsure if this is related to tracheostomies or other medical needs, but staff would need training on what to do in case of an emergency with a tracheostomy too.
------------------------------
Amy Callan
Health Educator and Training Specialist
contra Costa Health Services
Martinez CA
14157224723
------------------------------
Original Message:
Sent: 04-20-2024 06:59
From: Kristyn Moss
Subject: Ambulatory Suction Scope
Hello-
I am looking to see how sites manage suctioning in satellite offices. Do you allow nurses to deep suction in ambulatory offices? Is there ever a situation the nurse would suction a patient with a ventilator? I am in pediatrics so generally the guardian suctions or they have a homecare nurse with them at appointments that performs the suctioning, so the nurses are not asked. We also recently developed education that using the "mushroom" tip nasal suction is in scope for medical assistants. I'm wondering what other ambulatory sites do as far as suctioning, and who is in scope to perform?
Thank you!