Geriatric patients are more likely to need suctioning than any other age group, especially as the COVID-19 pandemic continues to spread. Mortality in the young and healthy is low, but among older people it rises to 5 percent, and skyrockets to as high as 10 percent or more among the elderly.
Consequently, first responders may be reluctant to suction geriatric patients due to concerns about spreading the illness to this highly vulnerable age group. These tips for suctioning a geriatric patient in the COVID-19 era can help you protect your patient, mitigate the risks of suctioning, and slow the spread of a lethal pandemic.
Treat All Patients as COVID-Positive
There is no way to know for sure who has COVID or who has been exposed to it. Temperature and symptom checks are inadequate because your patient may be asymptomatic or presymptomatic. COVID testing is not fully reliable either, and rapid-result tests are less reliable, which means that a negative rapid result offers no guarantees. First responders and other medical providers should assume that every patient they see is COVID-positive and act accordingly.
Suction Only When Necessary
Routine suctioning is never appropriate. During a pandemic, it poses a danger to everyone. Emergency suctioning should be reserved only for patients who cannot clear their own airway, for patients who are actively aspirating or are at risk of doing so, and for when there is a clear airway obstruction. When a patient shows indications for suctioning, do not delay treatment. Though no medical procedure is without risk, the risks of delayed suctioning vastly outweigh any risks associated with emergency suctioning.
Practice Aggressive Prevention Measures
When suctioning a geriatric patient, you must minimize your risk of exposure and theirs. These strategies can help:
- Limit the number of people in the room to those who are absolutely necessary for the procedure. If a patient has severe anxiety or dementia, a support person may be necessary. Ensure they wear a mask.
- Consider setting up partitions to separate the patient from bystanders.
- Wear full personal protective equipment.
- Practice frequent handwashing before suctioning, before touching any equipment, after suctioning, and after cleaning the equipment.
- Never reuse equipment without sanitizing it. Promptly dispose of disposable attachments.
- Do not store dirty equipment. This can spread contamination and the virus.
- Be mindful of how airway trauma can intensify the effects of COVID-19. Practice a slow and diligent approach. Never rush suctioning.
Be Mindful of Geriatric Suctioning Issues
Even outside of a pandemic, suctioning geriatric patients can be risky. Be mindful of these potential suctioning issues:
- Changes in the anatomy may make it more difficult for the patient to cough, necessitating suctioning.
- Anatomical changes may also make the airway thinner and more vulnerable, increasing the risk of traumatic injuries and a difficult airway.
- Dental hardware such as dentures may break off, increasing the risk of choking.
- Elders are more vulnerable to aspiration and more likely to die when they do aspirate. Delaying suctioning can be life-threatening.
- Both dementia and mild cognitive impairment can make it more difficult for elders to understand what is happening. This is not an excuse for rushed or insensitive care. Make every effort to gain cooperation and to explain suctioning to the patient. Compassion is key here.
A global pandemic has changed much about the way we live. A once-routine trip to the grocery store now feels like a significant risk. Now is a great time to reevaluate your suctioning protocols. Emergency suction allows you to tend to patients wherever you find them, without delaying care. Even more importantly, you don’t have to spread viral particles and risk additional exposure for yourself by moving a vulnerable patient. We can help you find the ideal suctioning device for your organization with our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
