Airway suction, oxygen devices and nebuliser technique

Your progress

Saved on this device.

Target exams

Red flags

• A child whose SpO2 stays below target despite a correct device is not under-oxygenated for lack of oxygen; the cause is rising carbon dioxide, exhaustion, sepsis, or a pneumothorax needing the cause fixed, not the flow turned up
• Vagal bradycardia and desaturation can occur within seconds of a suction pass; pre-oxygenate, limit each pass to about 5 to 10 seconds, and watch the monitor throughout
• A simple face mask run below 5 to 6 L/min lets exhaled carbon dioxide rebreathe; never turn a simple mask down to 'low'
• Dry, unhumidified high-flow oxygen dries and damages the airway mucosa and inspissates secretions; high-flow oxygen must be heated and humidified
• Unnecessary high oxygen in a preterm infant causes retinopathy of prematurity, and liberal oxygen may harm critically ill children; give oxygen to a target, not to the maximum
• A crying child deposits almost all a nebulised dose in the mouth; calm the child and aim for quiet tidal breathing before the dose is wasted

Life stages

Care settings

Clinical exam formats

Board mappings

• Performs safe oropharyngeal and nasopharyngeal suction in a child, with correct catheter selection and monitoring
• Selects and applies the correct oxygen delivery device for the child's need and sets a target SpO2
• Sets up and supervises a jet nebuliser and recognises when a spacer with metered-dose inhaler is preferred
• Justifies oxygen device choice and FiO2 by the entrainment principle and the child's inspiratory demand
• Leads escalation from low-flow oxygen to high-flow nasal cannula and non-invasive support using current evidence
• Applies aerosol physics and evidence-based drug dosing to optimise nebulised therapy and avoid common errors
• Bedside technique for airway suction, oxygen delivery device selection, and nebuliser setup in an acutely ill child
• Setting and achieving a target SpO2 and recognising deterioration
• Communication of the immediate respiratory support plan to the team and family
• Recognition of when suction, oxygen escalation, or nebulised therapy is needed and when to escalate
• Interpretation of a child failing to improve despite apparently correct device therapy
• Safety-netting and family communication around respiratory support at home and on discharge
• Level 1: Performs suction, applies low-flow oxygen, and sets up a nebuliser under supervision
• Level 2: Selects devices by clinical need, sets and achieves oxygen targets, and recognises when to escalate
• Level 3: Leads the respiratory support plan and integrates device choice with the underlying diagnosis
• Classification of oxygen delivery devices into variable- and fixed-performance, with their FiO2 and flow ranges
• Aerosol physics: how droplet size, driving flow, mask fit and child behaviour determine drug delivery
• Doses of nebulised salbutamol and ipratropium, and the evidence favouring spacer-MDI for acute asthma
• Demonstration of suction technique, oxygen device selection, and nebuliser setup on a manikin or child
• Structured assessment of a child's response to respiratory support
• Communication of the oxygen target, the device, and the safety-net to the family
• Recognition and correction of hypoxaemia with the appropriate oxygen device and target saturation
• Safe airway suction and nebuliser technique in infants and children
• Evidence-based choice between spacer-MDI and nebuliser, and escalation to high-flow support
• Performs oropharyngeal and nasopharyngeal suction safely with monitoring
• Applies and titrates oxygen devices to a target saturation
• Sets up a nebuliser and selects the correct drug and dose for acute wheeze
• Canadian approach to paediatric suction, oxygen delivery, and nebuliser technique
• Device classification, FiO2 and flow ranges, and target saturations
• Escalation from low-flow to high-flow nasal cannula and the evidence base