A nurse is preparing to suction a patient via the nasotracheal route.Which conditions should the nurse recognize as contraindications to nasotracheal suctioning? (Select all that apply. )

A) Motor vehicle accident with acute head injuries
B) History of hemophilia
C) Epiglottitis or croup
D) Environmental allergies with sinus drainage

Contraindications to nasotracheal suctioning include facial or neck trauma/surgery,acute head injuries,bleeding disorders,nasal bleeding,epiglottitis or croup,laryngospasm,irritable airway,and gastric surgery.These conditions are contraindications because the passage of a catheter through the nasal route causes additional trauma,increases nasal bleeding,or causes severe bleeding in the presence of bleeding disorders.In the presence of epiglottitis,croup,laryngospasm,or irritable airway,the entrance of a suction catheter via the nasal route causes intractable coughing,hypoxemia,and severe bronchospasm;this may necessitate emergency intubation or tracheostomy.Allergies with sinus drainage will increase the volume of secretions in the pharynx and may require suctioning.