Hyperoxygenation is the clinical practice of providing high concentrations of oxygen to a patient to increase arterial oxygen levels before a procedure. In airway management, clinicians learn how to hyperoxygenate before suctioning to create an oxygen reserve that mitigates the risk of procedure-induced hypoxia. Because hypoxia is a common and preventable complication of suctioning, following proper preoxygenation protocols is essential for patient safety.
Key Takeaways
Hyperoxygenation creates a vital oxygen reserve to prevent hypoxia during airway suctioning procedures.
Clinicians must understand how to hyperoxygenate before suctioning to improve patient safety outcomes.
Suctioning removes both secretions and oxygen, making preoxygenation necessary to maintain patient stability.
Proper assessment of the airway is required before initiating any suctioning or oxygenation protocols.
Post-suctioning monitoring and supplemental oxygenation are critical phases of effective clinical airway management.
Sometimes hypoxia occurs following suctioning because the suctioning was ineffective at removing an obstruction. More frequently, suctioning itself is the culprit. During suctioning, a patient cannot breathe normally. Suctioning doesn’t just remove secretions; it also removes oxygen, so prolonged suctioning may increase the risk of a hypoxic state.
Limit tracheal suctioning to less than 15 seconds to lower the risk. In some cases, suctioning may also stimulate the vagus nerve, triggering bradycardia, hypoxia, and even fainting. In both scenarios, knowing how to hyperoxygenate before suctioning can improve outcomes.
Before oxygenating the patient, conduct an assessment to determine whether suctioning is necessary. Though there are no absolute contraindications to suctioning, no procedure—including suctioning—is risk-free. The most common indications for suctioning include:
Airway obstructions, especially when there is an obstruction from a trauma
Aspiration or suspected aspiration, such as when the patient is actively vomiting or bleeding into the airway
Airway secretions that the patient is unable to clear. A raspy cough, hoarse voice, or difficulty breathing may indicate that the patient cannot clear their airway.
First, wash your hands and put on a new pair of gloves before touching the patient to begin oxygenation.
The risks of hyperoxygenation are minimal, although it is possible that oxygenation can distribute contaminants or move secretions deeper into the airway. Monitor the patient for signs of distress and intervene if the patient begins to choke or aspirate.
Otherwise, the precautions you need to take before oxygenation are virtually identical to those you will use for suctioning:
Suctioning is only one phase of the airway management process. You must continue to monitor the patient after suctioning, paying close attention to vital signs and behavior. Most agencies recommend oxygenating the patient after suctioning. Post-suctioning oxygenation is doubly important in patients who exhibit signs of hypoxia before or during suctioning – oxygenate for 60 seconds after suctioning.
Portable emergency suction devices are versatile tools used to maintain airway patency in both emergency and routine clinical settings. Hospitals may use portable suction machines to comply with their obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA) or to treat patients experiencing respiratory distress in waiting rooms where wall-mounted suction is unavailable.
In emergencies, reliable, consistent suctioning is vitally important. The right portable suction machine quickly clears the airway without losing power during critical interventions. For help selecting the appropriate machine for your agency, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
Editor's Note: This blog was originally published in August 2022. It has been re-published with additional up-to-date content.