Endotracheal Suctioning Is Basic Intensive Care or Is it?: Commentary on article by Copnell et al. on page 405

Argent, Andrew C.

doi:10.1203/pdr.0b013e3181b9b55c

Cited by 10 publications

(3 citation statements)

References 37 publications

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“…22 ETS interventions included in the PAWS are representative of the most common adjunct interventions used within Australia and New Zealand; as such we intentionally excluded practices that are not specifically utilised in these healthcare settings (e.g., lignocaine installation). 23,24 This decision was made with the support of the expert panel. We also sought to provide guidance on important clinical questions surrounding ETS practice that were current areas of uncertainty, irrespective of evidence availability or quality.…”

Section: Context and Applicabilitymentioning

confidence: 99%

Appropriate use criteria for endotracheal suction interventions in mechanically ventilated children: The RAND/UCLA development process

Schultz¹,

Charles²,

Long³

et al. 2022

Australian Critical Care

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Objectives: Endotracheal suction is an invasive airway clearance technique used in mechanically ventilated children. This article outlines the methods used to develop appropriate use criteria for endotracheal suction interventions in mechanically ventilated paediatric patients. Methods: The RAND Corporation and University of California, Los Angeles Appropriateness Method was used to develop paediatric appropriate use criteria. This included the following sequential phases of defining scope and key terms, a literature review and synthesis, expert multidisciplinary panel selection, case scenario development, and appropriateness ratings by an interdisciplinary expert panel over two rounds. The panel comprised experts in the fields of paediatric and neonatal intensive care, respiratory medicine, infectious diseases, critical care nursing, implementation science, retrieval medicine, and education. Case scenarios were developed iteratively by interdisciplinary experts and derived from common applications or anticipated intervention uses, as well as from current clinical practice guidelines and results of studies examining interventions efficacy and safety. Scenarios were rated on a scale of 1 (harm outweighs benefit) to 9 (benefit outweighs harm), to define appropriate use (median: 7 to 9), uncertain use (median: 4 to 6), and inappropriate use (median: 1 to 3) of endotracheal suction interventions. Scenarios were than classified as a level of appropriateness. Conclusions: The RAND Corporation/University of California, Los Angeles Appropriateness Method provides a thorough and transparent method to inform development of the first appropriate use criteria for endotracheal suction interventions in paediatric patients.

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Section: Context and Applicabilitymentioning

confidence: 99%

Appropriate use criteria for endotracheal suction interventions in mechanically ventilated children: The RAND/UCLA development process

Schultz¹,

Charles²,

Long³

et al. 2022

Australian Critical Care

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“…Caregivers will also need to be aware of the potential complications of suctioning, such as infection, hypoxia, atelectasis, cardiac dysrhythmias, tracheobronchial trauma and pneumothorax [73,76,77]. …”

Section: Respiratory Technologymentioning

confidence: 99%

Respiratory Care Considerations for Children with Medical Complexity

Chiang

Amin

2017

Children

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Children with medical complexity (CMC) are a growing population of diagnostically heterogeneous children characterized by chronic conditions affecting multiple organ systems, the use of medical technology at home as well as intensive healthcare service utilization. Many of these children will experience either a respiratory-related complication and/or they will become established on respiratory technology at home during their care trajectory. Therefore, healthcare providers need to be familiar with the respiratory related complications commonly experienced by CMC as well as the indications, technical and safety considerations and potential complications that may arise when caring for CMC using respiratory technology at home. This review will outline the most common respiratory disease manifestations experienced by CMC, and discuss various respiratory-related treatment options that can be considered, including tracheostomy, invasive and non-invasive ventilation, as well as airway clearance techniques. The caregiver requirements associated with caring for CMC using respiratory technology at home will also be reviewed.

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“…Airway clearance cannot be accomplished via involuntary physiological mechanisms, hence collaborative nursing intervention such as endotracheal suctioning is mandatory to maintain the patient airway (Argent 2009).…”

mentioning

confidence: 99%

Effects of Normal Saline Instillation on Haemodynamic Parameters and Oxygen Saturation after Suctioning of Mechanically Ventilated Patient

Chauhan¹,

Patel²

2023

NJI

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When patient is critically ill the function of removal of secretions may be compromised leading to excessive pulmonary secretions. Airway suction is one of the most popular methods of clearing airway secretion. This study aimed to assess effects of normal saline instillation on haemodynamic parameters and oxygen saturation before and after suctioning and to find out the association with demographic variable. Pre-experimental (one group pre-test post-test) study design was used; 52 patients were enrolled using convenient sampling from Intensive Care Units. Observation checklist was used to collect needed data on haemodynamic parameters and oxygen saturation before 5 min and after 5, 10 and 15 min of suctioning. As a part of intervention normal saline was instilled during suctioning. Paired t test values with regard to blood pressure (t=11.41), heart rate (t=1.50), systolic blood pressure (t=8.43) and respiratory rate (t=13.64) were found significant (p'lt;0.05) after suctioning with normal saline. Repeated measures of analysis of variance F test suggest that there was significant difference in respiratory rate (F=10.98) and oxygen saturation (F=62.16) among patients was significant at level p'lt;0.05. Chi-square test concluded that level of consciousness was found significant with level of heart rate and age was significant with systolic blood pressure at p-value 'lt;0.05. The study findings revealed that saline instillation should not be used as a routine clinical practice as it increases the heart rate, respiratory rate and systolic blood pressure also there was no change in oxygen saturation.

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Endotracheal Suctioning Is Basic Intensive Care or Is it?: Commentary on article by Copnell et al. on page 405

Cited by 10 publications

References 37 publications

Appropriate use criteria for endotracheal suction interventions in mechanically ventilated children: The RAND/UCLA development process

Appropriate use criteria for endotracheal suction interventions in mechanically ventilated children: The RAND/UCLA development process

Respiratory Care Considerations for Children with Medical Complexity

Effects of Normal Saline Instillation on Haemodynamic Parameters and Oxygen Saturation after Suctioning of Mechanically Ventilated Patient

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