Infant nasal-pharyngeal suctioning: is it beneficial?

To identify and validate the indicators registered nurses (RNs) use when deciding whether or not infants experiencing respiratory illnesses require nasal pharyngeal (NP) suctioning.

The first part of this study involved 43 RNs completing a questionnaire that examined the assessment parameters RNs use in determining when to perform NP suctioning. The second part of this study involved assessing infants' respiratory status before and after NP suctioning to determine what, if anything, changed post suctioning.

The three assessment parameters most frequently used by nurses in determining the need for suctioning were pulse oximeter readings, visible secretions, and audible secretions. The only three parameters to show statistically significant improvement post suctioning were pulse oximeter readings, visible secretions, and audible secretions.

Nurses are using valid assessment parameters when determining the need for infant NP suctioning, and NP suctioning does improve certain aspects of infants' respiratory status. There are presumed benefits to NP suctioning. However, there are also potential risks. Nasal-pharyngeal suctioning can produce bradycardia, laryngospasm, cardiac dysrhythmias, and edema and trauma to mucous membranes (Oberc, 1991), tachycardia, emotional distress, bronchospasm, and cardiac arrest (Young, 1988). The procedure involves inserting a catheter into an infant's nose and advancing it to the back of the throat (pharynx) approximately 4-8 cm (Oberc, 1991). Once at the pharynx, suction is intermittently applied and the catheter is slowly removed. The purpose of NP suctioning is to clear the airway of an infant who is unable to do so independently. However, the effectiveness and outcomes of this procedure have not been supported by research.