Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.
Oropharyngeal and Tracheal Suctioning
The following guidance represents the position of the New York State Board for Speech-Language Pathology and Audiology, in consultation with the New York State Education Department's Board for Nursing. This position statement considers both the scope of practice of Speech-Language Pathology as well as the practical needs and patient safety considerations of providing patient care.
A New York State licensed speech-language pathologist (SLP) may be requested to suction material from the upper aerodigestive tract (oral cavity, oropharynx, pharynx, larynx, and/or upper trachea) of a patient during the delivery of patient care. While the Education law includes in the speech-language pathology scope of practice the diagnosis and treatment of speech, language and swallowing disorders, individual procedures involved in such care are not detailed. One such procedure is oropharyngeal and tracheal suctioning. Suctioning is an advanced technique.
The NY State Board for Speech-Language Pathology and Audiology recognizes the need to suction a client/patient in certain settings during assessment or treatment. While suctioning is often provided by a skilled nurse, respiratory therapist or physician, the SLP may perform the procedure in the course of patient care.
If a SLP is requested to provide oropharyngeal or tracheal suctioning, and agrees to provide such care, he/she should have established competency in this area. Competency should be based on appropriate didactic instruction, training in specific techniques and supervision in the performance of this procedure. It is assumed that the supervisor and the clinician will agree to a level of knowledge, skills and competency before the clinician performs suctioning independently. Medical and/ or nursing back-up should be available in case of any adverse reaction during the procedure.
A SLP may perform oropharyngeal suctioning only as a part of the diagnostic or treatment intervention provided by the SLP within the session of care. Suctioning is not a stand-alone procedure within the scope of practice of the SLP.
There should be appropriate written Policy and Procedures for the performance of suctioning by a SLP. The individual should be trained, authorized and approved for suctioning by the healthcare facility and should be knowledgeable in patient safety measures and universal precautions. Appropriate risk management procedures should be utilized.