Suctioning may cause direct stimulation of vagal nerve fibers, especially in an infant. Show Don appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions. OVERVIEWSputum is produced by cells lining the respiratory tract. Although production is minimal in the healthy state, disease states can increase the amount or change the character of sputum. Examination of sputum may aid with diagnosing and treating various conditions. In many cases, suctioning is indicated to collect sputum from a young pediatric patient. Suctioning may also be necessary for pediatric patients with developmental delays, regardless of age. A cough can possibly be elicited by tickling the back of the patient’s throat with the suction catheter. In addition to direct stimulation of vagal nerve fibers, suctioning may provoke coughing, vomiting, and aspiration of stomach contents and induce pharyngeal, laryngeal, and bronchial muscle constriction. In pediatric patients with endotracheal (ET) or tracheostomy tubes, sputum is easily aspirated from the trachea. Adolescents and older pediatric patients are usually able to produce a sputum specimen by coughing if they are given very clear instructions. Sputum for cytology, culture and sensitivity, and acid-fast bacilli (AFB) are the three major types of sputum specimens. Cytologic or cellular examination of sputum may identify aberrant cells or cancer. The most common types of diagnostic tests performed on sputum specimens include respiratory syncytial virus, influenza A and B, parainfluenza, rhinovirus, and enterovirus. Sputum collected for culture and sensitivity testing can be used to identify specific microorganisms to determine which antibiotics are the most sensitive. The AFB smear is used to support a diagnosis of tuberculosis (TB). A definitive diagnosis of TB also requires a sputum culture and sensitivity. Regardless of the test ordered, a sputum specimen should be collected first thing in the morning due to a greater accumulation of bronchial secretions overnight. SUPPLIESundefinedsupplies" data-show="supplies">Click here for a list of supplies. EDUCATION
ASSESSMENT AND PREPARATIONAssessment
Preparation
PROCEDURESputum Collection Using the Coughing and Expectorating Method
Sputum Collection Using Suction
MONITORING AND CARE
EXPECTED OUTCOMES
UNEXPECTED OUTCOMES
DOCUMENTATION
REFERENCES
Elsevier Skills Levels of Evidence
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