When should a respiratory therapist consider suctioning a patient on mechanical ventilation?

Suctioning a patient on mechanical ventilation is particularly warranted when the patient exhibits increased respiratory effort. This condition may indicate that secretions are obstructing the airway, leading to difficulty in ventilation and inadequate oxygenation. Increased respiratory effort can manifest as increased work of breathing, and in the context of mechanical ventilation, it could suggest that the ventilator is struggling to deliver adequate tidal volumes or maintain positive pressure due to blockage from mucus or other debris.

In contrast, while visible blood in the airway is a concerning sign, it does not automatically necessitate suctioning. The presence of blood may require careful evaluation and specific interventions rather than routine suctioning, which might cause further complications.

Suctioning patients who are awake and able to cooperate is generally approached with caution. Cooperative patients are often better able to manage their own secretions, and suctioning can be uncomfortable and provoke anxiety if they are not adequately prepared, making this a less pressing indication for suction.

Audible wheezing is often related to bronchospasm or airway obstruction, which can sometimes resolve with bronchodilator therapy rather than suctioning unless there are accompanying signs of retained secretions. Hence, while wheezing is a sign to be aware of, suctioning should be based more on the overall assessment